In 2016, the United States Preventative Task Force recommends screening for depression in adults, including postpartum women. Our purpose was to assess the prevalence of “screen-positive” postpartum women delivering within our system, and to determine if access to prenatal care (PNC) has a measurable influence on depression scale results.
The ten-question Edinburgh Postnatal Depression Scale was routinely administered to postpartum women in our hospital. A score of 10 or greater triggered physician notification and social services consultation. Multivariate analysis was performed to investigate correlations between positive postpartum depression scale in patients with no PNC (zero office visits), limited PNC (1 to 3 office visits) and adequate PNC (greater than 3 office visits).
A total of 970 women from January 2015 to May 2015 were included. The sample distribution consisted of 81% with adequate PNC (n=786), 12.7% no PNC (n=123), and 6.3% limited PNC (n=61). Scores of 10 or greater occurred in 21.1% (n=26/123) with no PNC compared to 10.9% (n=86/786) with adequate PNC (P=.003). A greater percentage of patients with adequate PNC had private insurance compared to those without PNC (23.5% vs 8.1%, P=.0001). Furthermore, significantly more patients with no PNC were self-pay compared to those with adequate PNC (37.4% vs 4.3%, P=.0001).
Few studies have confirmed inadequate PNC as a measurable variable for positive postpartum depression screen. Financial issues appear to be a confounding variable. Obstetrician surveillance for management of depression in this population is warranted. Further prospective, interventional studies can potentially use this cohort as a base.
University of Nevada School of Medicine, Las Vegas, NV
Financial Disclosure: The authors did not report any potential conflicts of interest.