Poster #80 - Risk Assessment During Pregnancy: Role of Depression Screening

• In Event: Poster Session 13

Abstract

Depression is the most common complication of pregnancy and postpartum period, affecting at least 13-15% of new mothers, leading to adverse outcomes for mothers and their babies(Becker, et al.,2016). Approximately 16-23% of new mothers experience moderate to severe symptoms of depression, and mild symptoms are seen in another 11-15% throughout the first year after birth(Mayberry, et al.,2010). Postpartum depression is associated with postnatal complications, including less interaction with newborns, emotional withdrawal, anxiety, and less sensitive parenting (Norcross, et al.,2020), thus, the importance of screening is essential. Approximately 14.5% of pregnant people experience a new episodes of depression (Breedlove & Fryzelka,2011). Prenatal depression symptoms do not differ much from other depressive disorders, including restlessness, elevated anxiety, negative thinking, and loss of interest. However, this condition continues to be under diagnosed and undertreated, despite increased awareness(Toohy,2012). A recent review showed that prenatal depression is a significant risk factor for postpartum depression(Norhayati et al., 2015), despite low screenings offered during the prenatal time point. Thus, the focus of this research project was to examine the rate of depression screening on primiparous pregnant people around 28 weeks of pregnancy, and 6 weeks postpartum.
Data was taken from electronic medical records from a total of N=5152 patients to examine screening frequency and prevalence of maternal depression. Only 150 patients received an Edinburgh Postnatal Depression Scale (EPDS) mental health screening at 28-weeks prenatally, and 3137 patients received an EPDS screening at 6-weeks postpartum. We were also interested in participants who received screenings during both pregnancy and the postpartum period, which then reduced the total participants to N=100.
Out of 5152 patients, less than .03% of people were properly screened for depression during pregnancy(n=150). Results indicated greater symptomology during the prenatal period, despite more pregnant people were screened during the postpartum period (63%;N= 3137), suggesting a strong need for increasing early screenings during pregnancy. Of Participants with prenatal EPDS screenings, 44.0% of participants had elevated depression symptoms with scores between 5-11, and 14.7% of participants met the diagnostic cutoff score of 12 or greater. Of participants with postpartum 6-week EPDS screenings, 35.5% of participants had elevated depression symptoms with scores between 5-11, and 2.5% of participants met the diagnostic cutoff score of 12 or greater.

Depression during pregnancy left untreated, can endure after birth. Due to low levels of prenatal screenings, and the greater prevalence of depression during pregnancy, maternal depression may affect more pregnant people than previously understood, due to the lack of screening efforts during pregnancy. Early detection of maternal depression is critical because depression can adversely affect maternal health and psychological well-being, and may interfere with early parenting and infant outcomes. Thus, reducing mental health problems of pregnant people might contribute to less negative birth outcomes, a reduction of stress during pregnancy, reduce postpartum depressive symptoms, and allow for more sensitive caregiving throughout the first year following birth. Risk assessment during pregnancy matters. Screening during pregnancy needs further examining as an important early time point for prevention and intervention services, and overall functioning.

Authors

• Pamela Linton Norcross, Meredith College
  Presenting Author

• Betty-Shannon Prevatt

• Rayna Maleki