Impact of an On-site Perinatal Mood Disorders Clinic in the Diagnosis and Management of Perinatal Depression [15A

Abstract

INTRODUCTION: Perinatal mood disorders are a widespread complication of pregnancy and the postpartum period, with negative effects for mother and child if left untreated. This study assessed health outcomes of women seen in an onsite Perinatal Mood Disorder Clinic (PMDC) intended to improve access to timely evaluation and treatment. METHODS: A retrospective chart review was performed of 120 patients seen at the PMDC between March 1, 2017 and June 1, 2018. The primary outcome was participants' Edinburgh Postnatal Depression Scale (EPDS) score at final visit, where score >12 indicated postpartum depression. Two-tailed t-tests compared initial and final EPDS scores. A multivariable linear regression model with robust standard errors estimated the relationship between patient characteristics and final EPDS score for patients with greater than one score, controlling for initial score, mood disorder history, treatment type, and demographics. RESULTS: Mean final EPDS score (11.04) was lower than mean initial score (16.54; P<.001), among n=57 with greater than one score. There was a significant decrease between initial and final score for those receiving pharmacotherapy (P<.001) and those receiving combination pharmacotherapy/counseling (P<.01), but not those receiving counseling only (P=.137). Initial to final EPDS score decreased significantly for those in ongoing treatment at study period end (P<.01) and those referred back to primary physicians (P<.001), but not for those referred to psychiatry (P=.256) or lost to follow-up (P=.540). CONCLUSION: Women treated at the PMDC showed improved EPDS scores. Therefore, the PMDC may be filling a gap in access to timely care for perinatal mood disorders.