Effects of Deployment on Depression Screening Scores in Pregnancy at an Army Military Treatment Facility

Smith, Denise C. CNM; Munroe, Michelle L. CNM; Foglia, Lisa M. MD; Nielsen, Peter E. MD; Deering, Shad H. MD

doi: 10.1097/AOG.0b013e3181eb6c84
Original Research

OBJECTIVE: To estimate the relationship of positive screening for depression during and after pregnancy with deployment status of the spouse.

METHODS: We conducted a retrospective cohort study by reviewing a departmental database of women who completed the Edinburgh Postpartum Depression Scale during pregnancy from 2007 to 2009. Per departmental protocol, screening is offered at the initial obstetric visit, at 28 weeks of gestation, and at 6 weeks postpartum. A score of 14 or higher was considered high risk for having depression, and referral for additional evaluation was recommended. Included in our survey was an additional question that asked if the patient's spouse was currently deployed, returning from deployment, preparing to deploy, or if no deployment was planned. All data were entered into an electronic database and statistical analysis performed comparing Edinburgh Postpartum Depression Scale scores at each time period and deployment status.

RESULTS: A total of 3,956 surveys were complete and available for analysis. The risk of a positive screen was more than doubled compared with the control group (no deployment planned) if the spouse was deployed during the 28–32 week visit (4.3% compared with 13.1%, P=.012) or the postpartum period (8.1% compared with 16.2%, P=.006).

CONCLUSION: Deployment status has a measurable effect on the prevalence of elevated depression screening scores during pregnancy and in the postpartum period. These findings suggest that more intense monitoring, assessment, and treatment may be warranted for this at-risk population.

LEVEL OF EVIDENCE: II

Spousal deployment has a significant effect on the prevalence of positive depression screening scores during pregnancy and the postpartum period.

From the Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington.

The opinions expressed herein are those of the author and do not reflect the official policy or position of the Department of the Navy, the Department of the Army, the Department of the Air Force, the Department of Defense, or the United States Government.

Presented November 15–18, 2009 at the Armed Forces District Meeting, American College of Obstetricians and Gynecologists, Honolulu, Hawaii.

Corresponding author: Denise C. Smith, 211 Coleton Drive, Copperas Cove, TX 76522; e-mail: denise.smith9@us.army.mil.

Financial Disclosure The other authors did not report any potential conflicts of interest.

© 2010 by The American College of Obstetricians and Gynecologists.