Perinatal Depression Screening Rates at an Urban OBGYN Clinic Open Access
Perinatal depression (PD) is a significant public health problem with negative consequences for pregnant women, mothers, and families. Given that one of the main risk factors for PD is depression that occurs during pregnancy (Field, 2011), the American College of Obstetricians and Gynecologists (2015) recommends pregnant women be screened for depression at least once in both the prenatal and postpartum periods. In 2016, an obstetrics clinic in Washington, D.C. implemented universal screening for PD, in which women are screened at their first prenatal appointment (T1), in their third trimester (T2), and at 6 weeks postpartum (T3). T3 was previously incorporated into visits at this clinic since 2014. This study’s goal is to examine the rates of PD screening since the inception of the clinic’s new prenatal screening procedure. In an ongoing retrospective medical chart review (N=300 at study conclusion), data have been collected from 86 women randomly selected from ~3,000 women seen at the clinic from 7/1/2016 to 6/31/2017. Data include demographics, medical history, and referral information. The Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987) was used to screen for PD, and higher scores indicate more severity of depression symptoms. High risk for PD is based on EPDS scores ≥ 10. The sample was predominantly African-American (45.3%), married (57.0%), high school or college-educated (50.0%), employed (53.5%), and relatively young (M = 30.9 years, SD = 5.89). Of the 86 women, 41.8%, 31.3%, and 51.2% were screened at T1, T2, and T3, respectively. Women reported low depressive symptoms (T1: M = 5.31, SD = 4.30; T2: M = 5.11, SD = 3.98; and T3: M = 4.61, SD = 3.76). Women meeting high risk criteria for PD were 11.1%, 7.4%, and 11.4% at T1-T3 respectively. Preliminary results suggest that screening for PD is not yet “universal” in this urban obstetrics setting. Less than half of the women were screened at all three time points, and only 1/3rd of all women were screened during the second trimester of pregnancy. Additional analyses of the complete dataset (N=300, anticipated by conference time) will be conducted to assess selected risk factors (e.g., history of mental illness) and current psychiatric treatment to determine whether women screened are more likely to have particular risk factors and/or receive treatment. Results from this study will enable the obstetrics program to evaluate the effectiveness of their new perinatal screening procedures and make changes to improve their system.
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