Universal versus risk factor-targeted early inpatient postpartum depression screening*. (May 2015)

• Record Type: Journal Article
• Authors: Berger, Elizabeth; Wu, Amy; Smulian, Elizabeth A.; Quiñones, Joanne N.; Curet, Sandra; Marraccini, Rory L.; Smulian, John C.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 28:Number 7(2015)
• Page Start: 739
• Page End: 744
• Publication Date: 2015-05
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2014.932764
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: To assess differences in two different approaches to early inpatient Edinburgh Postnatal Depression Scale (EPDS) screening (targeted risk factor screening versus universal screening).</p> <p> <italic>Methods</italic>: Retrospective study of two cohorts delivering from January 2010 to June 2010. Cohort 1 included 5-weeks of consecutive deliveries. Risk factors for a positive EPDS screen were determined by multivariable logistic regression. Cohort 2 included all delivering women in the subsequent 5 months who had the most common risk factor (history of mental illness) for postpartum depression identified from Cohort 1.</p> <p> <italic>Results</italic>: For Cohort 1 of universal screening (<italic>N</italic> = 322), 11 (3.4%) had positive screens with seven (63.6%) having a history of any mental illness yielding the number needed to screen to identify one EPDS positive mother of 29. For Cohort 2 (<italic>N</italic> = 215), there were 33 (15.3%) positive screens and the number needed to have a positive screen was 6. Without a history of mental illness, predictive models for a positive screen were poor with the number needed to screen of 80.</p> <p> <italic>Conclusions</italic>: Early EPDS screening targeted for those with a history of mental illness is an efficient way to identify postpartum women with active mental health problems, but may miss up to 36.4% of potential screen positive women.</p> </abstract>