Postpartum Depression Screening Research Articles

Domestic Violence Experience, Past Depressive Disorder, Unplanned Pregnancy, and Suicide Risk in the First Year Postpartum: Mediating Effect of Postpartum Depression.

This study aimed to examine the relationship between domestic violence, past depressive disorder, unplanned pregnancy, suicide risk, and postpartum depression among Korean women using a mediation model approach. A web-based, cross-sectional survey was performed from September 21 to September 30, 2022. Participants included 1,486 women in their first year postpartum from Chungnam Province, South Korea. The generalized linear model mediation was analyzed using the R-based Jamovi 2.3.21 version program. Of all participants, 8.7% had domestic violence experience, 7.5% had been diagnosed with depressive disorder by the doctor in the past, 33.0% had reported that the last pregnancy was unplanned, 39.9% had postpartum depression, and 11.2% of the participants had a suicide risk. Among the participants with a high risk of suicide, 34.4%, 37.5%, 53.1%, and 96.9% reported experiencing domestic violence, past depressive disorder, an unplanned pregnancy, and postpartum depression, respectively. Postpartum depression partially mediated the relationship between domestic violence, past depressive disorder, and suicide risk and completely mediated the relationship between unplanned pregnancy and suicide risk. Our findings highlight the necessity for screening and early intervention for suicide risk and postpartum depression from pregnancy to the first year postpartum.

DESCRIPTIVE STUDY THE CHARACTERISTICS OF MOTHERS WITH POSTPARTUM DEPRESSION SCREENING RESULTS ON THE SEVENTH DAY PUERPERIUM

Postpartum depression is a psychological disorder that occurs during the postpartum period. The incidence of postpartum depression in Indonesia is between 50-70%. The development of the baby and the mother’s social life can be severely affected by postpartum depression. Screening is necessary to anticipate the incidence of postpartum depression. The purpose of this study was to describe the characteristics of mothers with postpartum depression screening results on the seventh day of postpartum women. The design of this study was a quantitative descriptive with a cross-sectional approach. The population of 38 people used the total sampling technique so that the total sample was 38 people. The research instrument used a general data questionnaire and EPDS. The results of the study showed that postpartum mothers who experienced a risk of postpartum depression were 21.1%. Based on the characteristics, namely mothers aged 20-35 years (18.4%), primiparous (13.2%), spacing of children <2 years (8.7%), mothers who do not work (15.8%), and mothers with senior high school education (15.8%). The risk of depression experienced by postpartum mothers in Blimbing, Malang is thought to be caused by factors such as parity, distance between children and education level. Although in small numbers. Postpartum depression can have a negative impact on the mental health of the mother and the development of the child in the future, so depression screening needs to be tried so that the coverage of early detection of postpartum depression increases.

Unlocking the potential of wearable device wear time to enhance postpartum depression screening and detection.

Postpartum depression (PPD) is a mood disorder affecting one in seven women after childbirth that is often under-screened and under-detected. If not diagnosed and treated, PPD is associated with long-term developmental challenges in the child and maternal morbidity. Wearable technologies, such as smartwatches and fitness trackers (e.g., Fitbit), offer continuous and longitudinal digital phenotyping for mood disorder diagnosis and monitoring, with device wear time being an important yet understudied aspect. Using the All of Us Research Program (AoURP) dataset, we assessed the percentage of days women with PPD wore Fitbit devices across pre-pregnancy, pregnancy, postpartum, and PPD periods, as determined by electronic health records. Wear time was compared in women with and without PPD using linear regression models. Results showed a strong trend that women in the PPD cohort wore their Fitbits more those without PPD during the postpartum (PPD: mean=72.9%, SE=13.8%; non-PPD: mean=58.9%, SE=12.2%, P -value=0.09) and PPD time periods (PPD: mean=70.7%, SE=14.5%; non-PPD: mean=55.6%, SE=12.9%, P -value=0.08). We hypothesize this may be attributed to hypervigilance, given the common co-occurrence of anxiety symptoms among women with PPD. Future studies should assess the link between PPD, hypervigilance, and wear time patterns. We envision that device wear patterns with digital biomarkers like sleep and physical activity could enhance early PPD detection using machine learning by alerting clinicians to potential concerns facilitating timely screenings, which may have implications for other mental health disorders.

Who decides to follow the referral advice after a positive postpartum depression screening result? Reflections about the role of sociodemographic, health, and psychological factors from psychological consultations – a cross-sectional study

Background/objectivePostpartum depression (PPD), a common and severe mental health problem, affects about 13–20 % of new mothers. Despite the psychological intervention's effectiveness, referral uptake rates among affected women are low. In the article, we aim to characterise those new mothers who adhered to referral advice after a positive PPD screening result. Method9161 women had taken part in a midwife-led PPD screening. Those who scored equal to or more than ten points on the Edinburgh Postnatal Depression Scale (EPDS) were referred for psychological consultations (12 %, n = 1109). We used data gathered during the realization of a PPD prevention programme. The following measures were used: EPDS, a sociodemographic and health data survey, and psychological consultation cards. ResultsWe found that only 85 (8 %) of referred mothers later enrolled in psychological consultations. Those mothers who adhered to the referral advice had higher EPDS (total score) and EPDS – 3A anxiety scores than mothers who did not contact a psychologist. Moreover, they had a higher gestational age at birth and, on average, fewer children. More PPD symptoms, C-section experience, self-assessed good financial situation and a postgraduate higher education degree were predictors of seeking help. ConclusionA mother's decision to follow the referral advice is crucial in mental health prevention and should be treated as an addition to a separate step 2: referral in a 3-step PDD management process, with identification constituting a step 1, and intervention - a step 3.

Association of inpatient postpartum recovery with patient-reported outcome measures following hospital discharge: a prospective cohort study

BackgroundThe relationship between the quality of inpatient versus outpatient obstetric postpartum recovery is under-explored. We examined the association between inpatient reported quality of recovery with outpatient global recovery, pain severity, pain interference, anxiety, and depression screening scores postpartum.MethodsWe conducted a multicenter observational cohort study of women in labor who underwent vaginal, operative vaginal, or intrapartum cesarean birth. Subjects completed baseline assessments of pain, social support, anxiety, and depression in early labor. We assessed the Obstetric Quality of Recovery-10 (ObsQoR-10) on the day of discharge and the ObsQoR-10, Global Health Scale (GHVAS; 0–100), Brief Pain Inventory (BPI), and the Edinburgh Postnatal Depression Scale (EPDS) on postpartum day seven. We hypothesized that the ObsQoR-10 scores at discharge would be useful in predicting postpartum day seven measures of recovery and postpartum depression screening scores.ResultsWe consented 558 subjects, 551/558(98%) completed baseline assessments, 400/551(72%) completed the ObsQoR-10 tool, and 344/551(62%) completed an EPDS assessment. Median (1st, 3rd quartile) ObsQoR-10 scores were 78 (63, 90) at discharge and 85 (68,93) on postpartum day seven, (difference of 7 [99% CI 2 to 13], P < 0.001). GHVAS on postpartum day seven identified 204/344 (59%) of subjects with good recovery. An ObsQoR-10 score of > 86 at discharge had a RR of 1.5 [95% CI 1.2 to 1.8], P < 0.001 for good recovery at postpartum day seven, the EPDS identified 20/344 (5.8%) respondents with a score ≥ 13 on postpartum day seven. The area under the curve between the ObsQoR-10 at discharge with an EPDS ≥ 13 was 0.74 (99% CI 0.61 to 0.86, P < 0.001). The RR for an EPDS ≥ 13 on postpartum day seven with an ObsQoR-10 < 77 on the day of discharge was 7.8 (95% CI 1.8 to 33.8; P = 0.001).ConclusionsObsQoR-10 scores at discharge and postpartum day seven demonstrated increased obstetric recovery in the post-discharge period. The observed association between the ObsQoR-10 and the EPDS, suggests that the ObsQoR-10 might facilitate identification of women at increased risk of postpartum anxiety or depression. Identification of high-risk women at discharge may allow early interventions to reduce morbidity secondary to postpartum depression.

The effects of infant abdominal massage on the parental stress level among Chinese parents in Hong Kong – A mixed clustered RCT

ObjectiveTo investigate the effectiveness and the experience of infant abdominal massage on reducing the parental stress level.MethodsA clustered RCT was conducted, 160 parents were recruited from 10 mother groups. An infant abdominal massage class was given to those in the intervention group by a certified International Association of Infant Massage instructor. The Chinese Parenting Stress Index (PSI-SF) was used to measure parental stress levels at baseline and 4 weeks after the intervention. 8 parents from the intervention group were invited for an online interview to understand the experience of parents in participating the infant abdominal massage class. Thematic analysis was applied.ResultsThe parental stress level was significantly decreased among intervention group with a mean difference of -5.46 (95% CI = 0.72 to 10.2, p = .049). ITT analysis was adopted for compliance analysis. The overall compliance for the intervention was 66% and found to have a significant effect on parental stress level (p < .01). The total PSI-SF among fathers was slightly higher than that among mothers. Furthermore, no moderating factors were found to have a significant interaction effect on PSI-SF (p < .05).For qualitative data, an overarching theme was generated that infant abdominal massage brought a positive experience despite the uncertainties affecting the compliance. Four themes and nine sub-themes were identified. Which were: (1) receiving clear and informative infant abdominal massage classes; (2) The influence of uncertain conditions on compliance; (3) Improving parental satisfaction; and (4) feeling it was a worthwhile experience.ConclusionThis study provides a cost-effective method for parents to tackle their parental stress, the findings aid in the planning or adjustment of current postpartum depression screening while also helping to lower the risk of postpartum mood disorders.Trial registrationClinical Trial Number (NCT05650424 || http://clinicaltrials.gov/study/NCT05650424), registered on December 1, 2022. and HKU Clinical Trails Registry (HKUCTR3008), registered on November 3, 2022.

The association between perinatal depressive symptoms and child neurodevelopment

BackgroundPerinatal depression has been suggested to adversely impact child neurodevelopment. However, the complexity of the early childhood environment challenges conclusive findings. ObjectiveTo evaluate whether there is an association between perinatal depressive symptoms and child intelligence quotient (IQ) at 5 years of age. Study DesignSecondary analysis of an ancillary study to a multicenter randomized trial of thyroxine therapy for pregnant individuals with subclinical hypothyroidism. Dyads of infants and birthing parent, with completed Center for Epidemiological Studies-Depression (CES-D) screens during pregnancy and postpartum and child neurodevelopment testing completed at five years of age (n=209) were included. CES-D screening was performed at 11–20 weeks, 34–38 weeks, and one-year postpartum. Depressive symptoms were categorized as antenatal (i.e., a positive screen at any point during pregnancy) or postpartum. The primary outcome was child IQ score < 85 at 5 years of age using the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) Full Scale test. Secondary outcomes included other assessments of childhood neurodevelopment. Bivariable analyses and multivariable logistic regressions were utilized. ResultsOf the 209 birthing people included, 72 (34%) screened positive for depression during pregnancy and 32 (15%) screened positive one year postpartum. Children born to individuals with a positive antenatal depression screen had a higher odds of IQ < 85 at 5 years of age compared with children born to individuals with a CES-D < 16 (35% vs. 18%, OR 2.4, 95% CI 1.2–4.7). Similar findings were seen for children born to individuals with a positive postpartum depression screen (47% vs. 21%, OR 3.3, 95% CI 1.5–7.3). These associations did not persist in multivariable analyses that controlled for social determinants of health and clinical characteristics (adjusted odd ratio [aOR] 1.4, 95% CI 0.7–3.1; aOR 2.1, 95% CI 0.9–5.1, for antenatal and postpartum depressive symptoms, respectively). Similar findings were observed for other adverse neurodevelopmental outcomes. ConclusionsHaving a positive perinatal depression screen was not associated with child cognitive outcomes after controlling for covariates including social determinants of health.

Incidence of postpartum depression among women with postpartum haemorrhage in Kano, northern Nigeria

The burden of postpartum depression (PPD), an important but largely neglected cause of maternal morbidity, is often increased by the presence of common co-morbidities, such as postpartum haemorrhage (PPH). Additionally, stress and the absence of social support can amplify PPD risk. Understanding the relationship between these conditions will help identify at-risk women and allow prompt intervention. Using a prospective cohort design, we recruited 72 women who had experienced PPH and another 72 women who had not within 24 h of delivery to assess the risk of PPD among them. The cumulative incidence of PPD among all participants was 15.3% (19/124). There was insufficient evidence to suggest that women with PPH have a higher risk of PPD than women without PPH (OR: 1.32; 95% CI: 0.55–3.13). Poor social support and high perceived stress increased the risk of PPD. We recommend screening for PPD among women with high perceived stress and low social support.

Substance Use Disorder as a Risk Factor for Postpartum Depression: A Retrospective Chart Review in a Community Hospital.

This retrospective study examines the relationship between postpartum depression (PPD) and substance use disorder (SUD) in a community hospital setting. This retrospective chart review explored the association between SUD and PPD in a community hospital. Data from January 2016 to December 2018 were extracted from electronic medical records (EPIC EMR (Epic Systems Corporation, Verona, WI)), identifying mothers with PPD (n = 99) using billing code F53.0. Substance use disorder was assessed using diagnostic codes F10-F19. Odds ratios (OR), relative risk (RR), and chi-square tests were calculated to quantify and assess the significance of the association between SUD and PPD. Ethical approval was obtained from the Institutional Review Board (IRB). Among 2,517 deliveries during the study period, 51 cases of PPD co-occurred with SUD. Mothers with SUD had a 4.3 times higher risk of PPD compared to those without SUD (OR = 4.8), highlighting a significant association. These findings emphasize the importance of screening for PPD and SUD in pregnant and postpartum women, especially in community healthcare settings where routine screening may be limited. Targeted interventions can mitigate adverse effects on maternal and infant well-being.

Massachusetts Medicaid ACO Program May Have Improved Care Use And Quality For Pregnant And Postpartum Enrollees.

Value-based care models, such as Medicaid accountable care organizations (ACOs), have the potential to improve access to and quality of care for pregnant and postpartum Medicaid enrollees. We leveraged a natural experiment in Massachusetts to evaluate the effects of Medicaid ACOs on quality-of-care-sensitive measures and care use across the prenatal, delivery, and postpartum periods. Using all-payer claims data on Medicaid-covered live deliveries in Massachusetts, we used a difference-in-differences approach to compare measures before (the first quarter of 2016 through the fourth quarter of 2017) and after (the third quarter of 2018 through the fourth quarter of 2020) Medicaid ACO implementation among ACO and non-ACO patients. After three years of implementation, the Medicaid ACO was associated with statistically significant increases in the probability of a timely postpartum visit, postpartum depression screening, and number of all-cause office visits in the prenatal and postpartum periods, with no changes in severe maternal morbidity, preterm birth, postpartum glucose screening, or prenatal or postpartum emergency department visits. Changes in cesarean deliveries were inconclusive. Results suggest that implementing Medicaid ACOs in the thirty-eight states without them could improve maternal health care outpatient engagement, but alone it may be insufficient to improve maternal health outcomes.

Syrian refugee women's experiences of barriers to mental health services for postpartum depression.

To describe Syrian refugee women's experiences of the barriers to access mental health services for postpartum depression (PPD). A descriptive qualitative study was conducted. Fifteen purposefully selected Syrian refugee women who scored ≥10 on the Edinburgh Postnatal Depression Scale participated in the semi-structured telephone interviews. Transcripts were coded verbatim and analysed thematically according to the dimensions of Levesque's model of patient-centred access to healthcare. Data were collected between August 2022 and February 2023. Five themes with 14 subthemes were identified: (1) approachability covered lack of knowledge and misconceptions related to PPD and its treatment, lack of awareness of available psychosocial services and perceived need of mental health treatment; (2) acceptability comprised being a refugee, stigma of mental illness, cultural preferences of healthcare provider and language barrier; (3) availability and accommodation encompassed transportation barrier and location of the centre, no support for childcare and lack of time; (4) affordability included financial difficulties and health insurance coverage; (5) appropriateness comprised no screening for PPD and intermittent services with limited focus on mental health. The findings of this study reveal that Syrian refugee women experienced multi-faceted complex barriers to access mental health services for PPD. It is important for health professionals, including nurses, and policymakers to address the cultural mental health needs of this population and establish strategies to protect their legal and health rights. Our study has important practice and policy implications for establishing strategies designed specifically for refugee mothers to mitigate their perceived barriers to PPD treatment and ultimately improve their mental health. The Consolidated Criteria for Reporting Qualitative Research was used. No patient or public contribution. Participants were Syrian refugee women with PPD symptoms and contributed only to the interviews and member checking.

Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.

Mothers experiencing homelessness undergo significant stressors in addition to parenting stress, yet the rate and treatment of postpartum depression (PPD) within this population has yet to be explored. We assessed the risk for PPD and examined the changes in PDD and parenting stress following engagement in treatment. Participants included 182 mothers with infants 7 months of age or younger in a shelter setting. After initial assessment of PPD and parenting stress, families participated in Child-Parent Psychotherapy (CPP). Post assessment was then conducted after 16 weeks. CPP was successfully implemented with high levels of procedural and content fidelity (M = 0.99, SD = 0.04; M = 0.95, SD = 0.09, respectively), treatment satisfaction (94%; M = 4.83, SD = 0.52), and relatively moderate levels of intervention completion (53.8%). Following participation in CPP, mothers reported decreases in parenting stress (d = 0.51) and continuous PPD symptom severity (d = 0.43). The proportion of mothers with clinically elevated self-report PPD symptoms also decreased from 15.3 to 6.7% (p = .013). Lastly, improvements in total parenting stress predicted improvements in PPD symptom severity (B = 0.12, p < .001). The findings highlight the relevance of screening for PPD among mothers experiencing homelessness. Most importantly, relationship-based interventions like CPP demonstrate promise in indirectly treating PPD for at-risk populations and within a shelter setting.

Postpartum Insurance Loss: Predicting Factors, Associations with Postpartum Health Service Utilization, and the Role of Medicaid Expansion.

This study investigated the predictors of postpartum insurance loss (PPIL), assessed its association with postpartum healthcare receipt, and explored the potential buffering role of Medicaid expansion. Data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed, covering 197,820 individuals with live births. PPIL was determined via self-reported insurance status before and after pregnancy. Postpartum visits and depression screening served as key health service receipt indicators. The association between PPIL and maternal characteristics was examined using bivariate analysis. The association of PPIL with health service receipt was assessed through odds ratios derived from multivariate logistic regression models. The role of Medicaid expansion was explored by interacting ACA Medicaid expansion status with the dichotomous PPIL indicator. PPIL was experienced by 7.8% of postpartum people, with higher rates in Medicaid non-expansion states (13.6%) compared to 6.1% in expansion states (p < 0.05). Racial and ethnic disparities were observed, with 16.5% of Hispanic and 4.6% of white people experiencing PPIL. Individuals who experienced PPIL had decreased odds of attending postpartum visits (adjusted odds ratio (aOR) = 0.81, 95% CI = 0.73-0.90) and receiving screening for postpartum depression (aOR = 0.86, 95% CI = 0.78-0.96) compared to those who maintained insurance coverage. People in expansion states with no PPIL had higher odds of postpartum depression screening (aOR = 1.33, 95% CI = 1.08-1.62). No differences in postpartum visits in expansion versus non-expansion were noted (aOR = 1.13, 95% CI = 0.93-1.36). Ensuring consistent postpartum insurance coverage offers policymakers a chance to enhance healthcare access and outcomes, particularly for vulnerable groups.

Postpartum Depression Screening in Pediatric Primary Care Clinics and Infant Receipt of Preventive or Acute Care

ObjectiveTo evaluate the association between postpartum depression (PPD) screening results in pediatric primary care and subsequent infant preventive and acute care utilization. MethodsThis was a retrospective cohort analysis of 5341 infants born in 2021 whose mothers were screened for PPD at a well-child visit during the first 6 months. Logistic regression was used to examine that association between a positive PPD screen and 1) adherence to the 12-month well-child visit, and 2) any acute care visits (urgent care or emergency department visits) from 6–15 months. The association between PPD screen and number of acute care visits was examined with negative binomial logistic regression. ResultsThe incidence of positive PPD screens was 15.6% in the first 6 months. There was no significant difference in 12-month well-child visit adherence based on PPD screening (adjusted odds ratio (aOR): 0.91; 95% confidence interval (CI): 0.77–1.06; P-value: 0.206). The odds of having any acute care visit were higher among infants whose mothers screened positive for PPD (aOR: 1.2; 95% CI: 1.0–1.3; P-value: 0.009). There was a significant difference in the incidence rate of acute care visits based on PPD screening results (incidence rate ratio: 1.1; 95% CI: 1.0–1.2; P-value: 0.005). ConclusionsScreening positive for PPD was associated with subsequent acute care utilization but not 12-month preventive care. Primary care providers may need to proactively follow-up after acute care visits to ensure both infant health and maternal needs are met, connecting mothers to resources as needed.

Validation of the Chinese version of the Whooley questions for community screening of postpartum depression

BackgroundThe study aims to validate the Whooley questions for screening postpartum depression in Chinese women in a community setting. MethodsThe Whooley questions was translated into Chinese following Beaton's intercultural debugging guidelines. From December 1, 2020 to June 30, 2021, primary maternal and child health workers in Kaifu District and Changsha County in Changsha City recruited women aged 18 years or older who had recently given birth during home visits within seven days of discharge from hospital. Participants women completed the Whooley questions online and underwent a diagnostic interview for DSM-IV within 7 days of the visit. We evaluated Cronbach's alpha, split-half reliability, area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and optimal cut-off value of the Whooley questions. ResultsOf the 3,004 eligible women, 1,862 completed the Whooley questions and diagnostic interviews. Sixty-two women (3.3%) were diagnosed with depressive disorders. The Cronbach's alpha coefficient was 0.64, the split-half reliability was 0.64. The optimal cut-off value was when at least one questions was answered “yes”, with an AUC of 0.84 (SE=0.03, 95%CI 0.78–0.90, P<0.001), sensitivity of 0.77 (95%CI 0.65–0.87), specificity of 0.89 (95%CI 0.88–0.90), PPV of 0.20 (95%CI 0.15–0.25) and NPV of 0.99 (95%CI 0.98–1.00). ConclusionThis study shows that the Chinese version of the Whooley questions is a reliable tool for screening postpartum depression in the community, but it may lead to many false positive cases.

Depresión posparto: prevalencia y relación con la tipología y función familiar

Introduction: postpartum depression (PPD) is a public health issue. Multiple biological and psychosocial risk factors have been described. In Colombia there are no studies determining its prevalence based on screening scales and diagnostic criteria, as well as its relation to family functioning assessment instruments. Objective: to determine PPD prevalence in in women in the immediate postnatal period and its association with clinical conditions, life-course, and family typology and functioning. Materials and methods: an analytical cross-sectional observational study conducted in the immediate postnatal period (2 to 48 hours after delivery), using the Edinburgh scale (EPDS) and the DSM5 criteria for PPD screening and diagnosis. Sociodemographic variables such as, gynecological-obstetric, and perinatal history, and clinical conditions, were analyzed. Family functioning assessment instruments such as life-course, family typology and family APGAR, were applied. Results: 336 participants with a mean age of 27.3 years, were included. The prevalence of PPD was 5.1%, while prevalent pathologies were preeclampsia (8.3%) and gestational diabetes (6.3%). 58% (p&lt;0.001) had a dysfunctional family to some degree and 88% (p 0.01) belonged to nuclear families. No statistical significance was found for clinical conditions and life-course. Conclusions: PPD is a prevalent mental health issue caused by multiple factors, such as family typology and functioning. Further quantitative and qualitative studies to establish causal relationships, are needed, to better understand this phenomenon.

Universal screening of postpartum depression with Edinburgh Postpartum Depression Scale: A prospective observational study.

To assess the feasibility of universal screening of postpartum depression (PPD), using the Edinburgh Postpartum Depression Scale (EPDS) in the general population. To investigate the proportion of women identified as being at risk of PPD and with confirmed PPD or other mental disorders after a psychiatric consultation. A multicenter prospective cohort study in four French maternities conducted between 2020 and 2023. All women aged over 18 years, who delivered following a singleton pregnancy after 37 weeks of gestation were eligible for inclusion. The exclusion criteria were pre-existing psychiatric disorders such as depressive syndrome. The EPDS was completed at 8 weeks postpartum via an online self-administered questionnaire. If the response to the questionnaire suggested a mental disorder, a psychiatric consultation was proposed to the women concerned. The endpoints were the proportion of women completing the EPDS, the EPDS score, the proportion of women at risk of PPD, the proportion of psychiatric consultation, and the subsequent diagnosis. The study included 923 women, of whom 55.0% (508/923) completed the EPDS. Among them, 28.1% (143/508) had an EPDS score of 10 or more, and 11.2% (57/508) received a psychiatric consultation. PPD was confirmed in 8.8% (5/57) of women. Other disorders detected were mood disorders, disorders specifically associated with stress, and anxiety/fear-related disorders, in 33.3%, 28.1%, and 14.0% of the women, respectively. Screening with self-administered EPDS is feasible, with a good response rate, making it possible to suspect mental disorders, including PPD, and to offer psychological support when needed.

Educational Intervention for Pediatricians on Research and Resources for Moms with Postpartum Depression

Postpartum depression (PPD) is a serious condition that affects 13-19% of mothers who previously had postpartum blues. The American Academy of Pediatrics recommends that mothers receive screening for PPD at their infant’s well-child visits during months 1, 2, 4, and 6. The purpose of this intervention was to host an informational session for pediatric residents regarding current research and local/national resources for women with postpartum depression. We hypothesize that by doing this session, there will be a notable increase in the knowledge learned. The session was held at the Orlando Health Arnold Palmer Hospital for Children. Residents were given a pre-survey, a presentation, and then a post-survey immediately after. All surveys were online and given via Qualtrics. The presentation consisted of background information on postpartum depression, local specialists on maternal mental health, research supporting telemedicine, exercise, social interactions, and expressive writing as evidence-based methods to improve symptoms, and local/national resources for each respective field. Descriptive statistical analysis was used to analyze the differences in our pre-survey data versus. post-survey data. In comparing the pre to post-survey responses, an overall average of an 87% increase in knowledge occurred. Overall it was noted that all residents gained a better understanding of resources nationally and in the local community. Although limited by our sample size, N&lt;14, our study concluded that the residents who attended our session were able to screen and diagnose postpartum depression and were able to provide local resources to mothers. We were able to accept our hypothesis that creating an educational intervention where current research and resources regarding support for women with PPD is synthesized and presented to pediatricians, their knowledge on available tools accessible to mothers will increase.

An Evaluation of the Health Economics of Postnatal Depression Prevention and Treatment Strategies in China: A Cost-Effectiveness Analysis.

The primary objectives of this study are to assess the cost-effectiveness of early postnatal screening and prenatal psychological interventions for the prevention and treatment of postpartum depression (PPD) among Chinese pregnant women. Additionally, we aim to explore the most cost-effective prevention and treatment strategies for PPD in China. We used TreeAge 2019 to construct a decision tree model, with the model assuming a simulated queue size of 10,000 people. The model employed Monte Carlo simulation to assess the cost-effectiveness of PPD prevention and treatment strategies. Transfer probabilities were derived from published studies and meta-analyses. Cost and effectiveness data were obtained from published sources and relevant studies. Incremental cost-effectiveness ratios (ICERs) were used to describe the results, with willingness-to-pay (WTP) thresholds set at China's gross domestic product (GDP) per capita. Compared to the usual care group, the cost per additional quality-adjusted life year (QALY) for the early postnatal screening group and the prenatal psychological interventions is USD 6840.28 and USD 3720.74, respectively. The cure rate of mixed treatments for PPD has the greatest impact on the model, while patient participation in treatment has a minor impact on the cost-effectiveness of prevention and treatment strategies. Both early postnatal screening and prenatal psychological interventions are found to be highly cost-effective strategies for preventing and treating PPD in China. Prenatal psychological interventions for pregnant women are the most cost-effective prevention and treatment strategy. As such, from the perspective of national payers, we recommend that maternal screening for PPD be implemented in China to identify high-risk groups early on and to facilitate effective intervention.

Longitudinal Exploration of Prenatal and Postnatal Intimate Partner Violence, Postpartum Depression, and Child-Mother Attachment: A Mediation Model.

This longitudinal study examines the timelines of occurrences of intimate partner violence (IPV) on child-mother attachment, as well as the mediating role of maternal postpartum depression (PPD). Using a sample in the United States (N = 2,268), findings suggest that, compared to mothers' prenatal IPV victimization, postnatal IPV more negatively influences child-mother attachment when the children were at 3 years old, and this negative impact on attachment was partially mediated through maternal PPD. As IPV screening for pregnant women in healthcare settings becomes a common practice, effective IPV and PPD screening postnatally should be broadly implemented to promote maternal mental health and child-mother attachment.