Integration of depression screening in to timetable prenatal and postpartum obstetric care is not just feasible however can easily additionally cause relatively higher levels of linkage to evaluation, diagnosis, and treatment of depression for women that screen positive, a brand-new study suggests.
Kartik K. Venkatesh, MD, PhD, from Massachusetts Total Hospital and Brigham and Women’s Hospital, Boston, and colleagues published the outcomes of their prospective observational cohort study online Could 19 in the American Diary of Obstetrics and Gynecology.
“Among nearly 9000 women that were initially screened for depression, 576 (7%) screened beneficial (i.e. EPDS [Edinburgh Postnatal Depression Scale] ≥12), and close to 80% were linked to psychological healthiness services, among whom over three-fourths were diagnosed along with significant depression and/or an anxiety disorder,” the authors write. “Women were substantially much more most likely to follow game a psychological healthiness evaluation if they screened beneficial for depression antepartum quite compared to postpartum.”
Depression throughout pregnancy is common, affecting up to 18% of women, and has actually been associated along with side outcomes for the two the mother and infant. Yet maternal depression throughout pregnancy is not constantly diagnosed and/or treated adequately, despite evidence showing that treatment is beneficial.
The American College of Obstetricians and Gynecologists now recommends that clinicians usage a standardized device to screen women for depression at the very least when throughout the perinatal period. In addition, the US Preventive solutions Task Pressure recently published guidelines recommending timetable depression screening in women the two throughout pregnancy and postpartum.
However, devoid of interventions after timetable screening throughout pregnancy, fewer compared to 1 in 5 women that screen beneficial for depression could be linked to further psychological healthiness solutions by their clinician.
Dr Venkatesh and colleagues therefore aimed to find out the feasibility of large-range implementation of universal screening for depression in women throughout the two pregnancy and postpartum. They used the EPDS, which is a 10-item questionnaire along with psychometric properties that is widely used to evaluate depressive symptoms in pregnant and postpartum women. An EPDS cutoff score of 12 or better was used as a beneficial indicator of depression.
The authors analyzed data from July 2010 through June 2014 from 8985 women that were enrolled in prenatal care at a tertiary academic medical focus in which a timetable depression screening regimen had been implemented. Of these, 8840 women (98%) were screened antepartum, and 7780 (86%) were screened postpartum. A total of 576 women (7%) screened beneficial for depression: 396 (69%) screened beneficial antepartum and 180 (31%) screened beneficial postpartum (P < .01).
Among women that screened beneficial for depression, 455 (78.9%) were formally evaluated by a psychological healthiness provider, and evaluation taken place much more usually antepartum compared to postpartum (82.5% vs 71.1%; P < .002); 39% of these women were diagnosed along with significant depression only, 10% along with an anxiety disorder only, and 28% along with the two significant depression and anxiety. Among those that were diagnosed along with depression and/or anxiety, 35% received antidepressant medication; this taken place much more often postpartum compared to antepartum (54% vs 28%; P < .0001).
Dr Venkatesh and colleagues additionally discovered that women were substantially much more most likely to link to psychological healthiness solutions if they screened beneficial for depression throughout pregnancy compared to postpartum (adjusted odds ratio, 2.09; 95% self-confidence interval, 1.24 – 3.24; P = .001), after adjusting for patient and demographic factors.
The outcomes of this study suggest that timetable depression screening in women, the two throughout pregnancy and postpartum, can easily cause higher levels of psychological healthcare usage among women that screen positive.
However, “further data are required about methods to promote referral postpartum, too as lasting psychological healthiness follow-up and outcomes complying with first psychiatric evaluation after obstetric referral,” the authors conclude.
The authors have actually disclosed no conflicts of interest.
Am J Obstet Gynecol. Published online Could 19, 2016. Abstract
