Postpartum Depression Screening Research Articles

A Prospective Observational Study to Find out the Characteristics of Postpartum Depression (PPD) and to Assess the Impact of Pharmacist Led Counselling among the Females with PPD

Published on:June 2022 Journal of Young Pharmacists, 2022; 14(2):214-220 Original Article | doi:10.5530/jyp.2022.14.40 Authors: Rajesh Hadia1,*, Krishna Bhavsar1, Riddhi Patel1, Vidhya Shivadas1, Kushalkumar Gohel1, Rita Gaikwad2, Hemrajsingh Rajput1 1Department of Pharmacy Practice, Sumandeep Vidyapeeth (Deemed University), Vadodara, Gujarat, INDIA. 2Department of Gynecology, SBKS Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed University), Vadodara, Gujarat, INDIA. Abstract: Objectives: The study aimed to identify patterns of postpartum depression prevalence, risk factors and to assess the impact of pharmacist-led counselling among depressed postnatal. Methods: This was a Prospective Observational study conducted with a sample of 120 women. PPD screening was done using DASS-21 (Depression, Anxiety and Stress Scale) and EPDS (Edinburgh Postnatal Depression) questionnaires on the 1st day postpartum, and even on the 2nd and 4th week postnatal. The depressed women were given interventional treatment for supportive counselling. Results: The prevalence rate of PPD using EPDS was 34.17% on 1st day postpartum, 37.5%, and 4.16% on the 2nd and 4th week postpartum respectively. Similarly, using DASS-21 it was found 21.67%, 15.83%, and 2.5%. The associated risk factors were women’s age (<30), lower education, number of child (>2), more than one girl children, Adverse life related events, and low level or lack of support from partner and In-laws. DASS-21 scale was useful screening tool than the EPDS scale. After providing counselling the number of depressed women decreased. Conclusion: High prevalence rate of PPD was found in which socio-cultural factors play a major role. Sometimes anxiety and stress co-exist with depression, thus it is postnatal distress that should be aimed for and for which an efficient screening tool should be used.Keywords: Postpartum depression/Postnatal depression, Prevalence, Risk-factors, EPDS scale, DASS-21 scale.

Further validation of the European and Brazilian Portuguese short version of the Postpartum Depression Screening Scale-7

IntroductionWe have recently validated the Portuguese shortest version of the Perinatal Depression Screening Scale-PDSS-7 (items selected from the PDSS-21; each one representing a dimension evaluated by the PDSS-35), for the assessment of depression severity in pregnancy, both in Portugal and Brazil.ObjectivesTo analyze the validity and reliability of the PDSS-7 Portuguese version to evaluate postpartum women both from Portugal and Brazil.MethodsThe Portuguese sample was composed of 304 women between the 2nd-6th postpartum months (Mean=20.09±7.21 weeks postpartum). These participants were not the same who participated in the psychometric study that led to the selection of the seven items. The Brazilian sample was composed of 121 women (Mean=10.51±4.53 weeks postpartum). All the participants completed the European/Brazilian Portuguese versions of PDSS-21, which was composed of the same items and included the seven items of PDSS-7. Participants also filled in the validated versions of Perinatal Anxiety Screening Scale and Profile of Mood States.ResultsConfirmatory Factor Analysis revealed that the unidimensional model of PDSS-7 presented acceptable/good fit indexes in both samples (Portuguese/Brazilian: χ2/d.f.=2.6598/1.7897; RMSEA=.0740/.0807, CFI=.8289/.7934, TLI=.7901/.8434, GFI=.9298/.9496; p&lt;.001). The PDSS-7 Cronbach’s alphas were of .841/.856 and all the items contributed to the internal consistency. Pearson correlations with postpartum anxiety (.646/.763) and negative affect (.666/.676) were significantly (p&lt;.01) high. PDSS-7 mean scores were higher in the Brazilian sample (16.06±7.39 versus 11.37±4.37, p&lt;.01).ConclusionsPDSS-7 presented validity (construct and convergent), reliability and utility in clinical and research settings, including in transcultural studies, in Portugal and Brazil, namely in the postpartum.DisclosureNo significant relationships.

Screening Accuracy of the Portuguese version of the Postpartum Depression Screening Scale-7 according to DSM-5 criteria

IntroductionThe Portuguese shortest version of the Perinatal Depression Screening Scale/PDSS-7 proved to be valid and reliable, in Portugal and Brazil, but it is essential to analyze its operational characteristics before using it for screening purposes.ObjectivesTo determine PDSS-7 cut-off points and associated conditional probabilities to screen for major depression, according to the DSM-5.Methodshe pregnancy sample was composed of 259 women in the second trimester (Mean gestation weeks=17.83±4.750). The postpartum sample consisted of 241 women assessed between the 2nd-6thmonths postpartum(M=17.99±4.689 weeks postpartum). All women completed the PDSS-7 and were interviewed with the Diagnostic Interview for Psychological Distress(Pereira et al., 2017), a semi-structured clinical interview to assess the most prevalent psychiatric disorders in the perinatal period according to the DSM-5 criteria. MedCalc was used to perform ROC analysis.ResultsDuring pregnancy, the major depression prevalence was of 4.6%(n=12). The cut-off point that maximizes the Youden Index(J=.98, 95%CI: .97-.99; AUC=.99; se=.004; p&lt;.001) was of 18(95%CI:17-19), which resulted in a sensitivity of 100%(71.5%-100%), a specificity of 97.98%(95.3%-99.3%), a positive predictive value/+PP of 68.8%(48.0%-84.0%) and a negative predictive value/-PP of 100%. In the postpartum, the major depression prevalence was of 10.4%(n=25). The cut-off point(J=.79, 95%CI: .63-.82; AUC=.89; se=.036; p&lt;.001) was of 14(95%CI: 12-16), with a sensitivity of 85.0%(69.3%-93.2%), a specificity of 85.0%(69.3%-93.2%), a +PP of 56.5%(46.1%-67.3%) and a -PP of 97.5%(94.6%-98.8%).ConclusionsThe Portuguese version of PDSS-7 presents good combinations of sensitivity and specificity, being accurate and usable to screen for depression during pregnancy and in the postpartum both in research and primary health care.DisclosureNo significant relationships.

Prevalence of Postpartum Depression among Women in Childbearing Age Attending Primary Health Care Centres, Qassim Region.

Postpartum Depression (PPD) is a significant threat to mothering and has negative impact on both mothers and children. There is limited information about PPD prevalence and associated factors in Saudi Arabia particularly in Qassim region. This study aimed to determine the prevalence of PPD and factors associated with PPD among women of childbearing age in Buraidah, Qassim region, Saudi Arabia. This was a cross sectional study including 204 mothers aged 18-45 years in postpartum period attending primary health care centres in Buraidah during April to August 2021. A self-administered questionnaire was used to gather data regarding socio-demographic characteristics, newborn related factors, marital and family relationship factors, and social support factors of the participants. Edinburgh Postnatal Depression Scale (EPDS) was used to determine PPD among the participants. Out of 229 invited women, 204 willingly participated (response rate: 89.1%). More than half of the participants (58.3%) belonged to 18-30 years age group; 62.3% participants had university or above education; 82.4% were housewives; and household income level was considered 'moderate' by 65.7% of the participants. According to EPDS, the prevalence of PPD was 13.7% while 17.6% had 'possible Post-Partum Depression', and 12.3% had 'fairly high possibility of Depression'. PPD was significantly associated with friend support (p=0.03) husband support (p=0.01) and absence of conflict with the husband (p=0.02). More than a quarter of women were likely to have PPD needing monitoring, diagnostic assessment and possible treatment by primary health care physicians or specialists. Comprehensive post-natal care including screening for PPD in primary health care centers is recommended.

Screening for Postpartum Depression During Infant Well Child Visits: A Retrospective Chart Review.

The American Academy of Pediatrics (AAP) recommends that pediatricians screen mothers for postpartum depression (PPD) at the infant's 1, 2, 4, and 6-month well child (WC) visits. Despite these recommendations, less than 50% of mothers are screened nationally. We evaluated the impact of a statewide quality improvement initiative that implemented routine screening for PPD utilizing the Edinburgh Postpartum Depression Scale (EPDS) at AAP recommended WC visits. A total of 224 patients were included. Screening rates increased significantly at all four WC visits (P < .01). A higher prevalence of positive EPDS screens was detected in mothers with a history of a mental health condition (P = .009) and in mothers who reported recent food or housing insecurity (P = .02). EPDS screening was successfully implemented through a statewide initiative in a busy hospital-based pediatric clinic. Pediatricians play an important role in identifying mothers with PPD and referring them to adequate treatment.

Perinatal Complications, Poor Hospital Treatment, and Positive Screen for Postpartum Depressive Symptoms Among Black Women.

Though mandatory screening for depression during pregnancy and the postpartum period is recommended, postpartum depression is still underdiagnosed and overlooked among Black women. Understanding risk factors during pregnancy and delivery that may increase the risk for postpartum depression is important for Black women. Thus, the purpose of this study is to examine the relationship between perinatal complications (i.e., preterm birth, low birth weight, gestational diabetes, unplanned cesarean section, undesired pregnancy, depression during pregnancy), poor hospital treatment, and postpartum depressive symptoms (i.e., depressed mood, anhedonia, and positive screen on PHQ-2) among Black women. Using the Listening to Mothers III survey, we conducted logistic regression analyses in a nationally representative sample of 368 Black women to examine the relationship between perinatal complications, poor hospital treatment, and positive screen for postpartum depressive symptoms, measured by the Patient Health Questionnaire-2 (PHQ-2). We also examined these factors in predicting anhedonia and depressed mood. Poor hospital treatment was associated with a positive screen for postpartum depression, anhedonia, and depressed mood. Perinatal complications, when measured continuously, were associated with a positive screen for depression and depressed mood. Gestational diabetes and preterm birth were associated with depressed mood while depression during pregnancy was associated with anhedonia. Perinatal complications during pregnancy and delivery may increase the risk for postpartum depression among Black women. When screening for postpartum depression, it may also be important to inquire about poor hospital treatment and stressors emanating from these experiences.

Experiences of racism and postpartum depression symptoms, care-seeking, and diagnosis.

Postpartum depression (PPD) is common and disproportionately affects people of color. Experiences of emotional upset due to racism (EUR) may be an important predictor of PPD outcomes. Therefore, we aimed to determine if EUR during the 12months before delivery was associated with PPD symptomology, asking for help for depression, and depression diagnosis among postpartum people of color (PPOC). We conducted a cross-sectional secondary data analysis among PPOC from 11 states and New York City using PRAMS data, 1/1/2015-12/31/2017. We assessed symptomology using an unvalidated PHQ-2. Logistic regression was performed without and with stratification by ethnicity (non-Hispanic PPOC vs Hispanic PPOC) to estimate whether EUR during 12months before delivery was associated with (1) PPD symptoms, (2) asking for help for depression, and (3) depression diagnosis. Models adjusted for age, educational attainment, timely prenatal care, payment method, stress during pregnancy, and pre-pregnancy depression. Seventy-four thousand nine hundred nine (11.8%) PPOC reported EUR in the 12months before delivery. After adjustment, EUR was associated with a 10.3 percentage point (%pt; 95% CI: 6.8, 13.8), 13.6%pt (95% CI: 8.8, 18.5), and 4.1%pt (95% CI: 1.4, 8.0) higher probability of positive PPD screening among all PPOC, non-Hispanic PPOC, and Hispanic PPOC, respectively. EUR was not associated with asking for help for depression but was associated with a higher prevalence of depression diagnosis among all PPOC (4.6%pt; 95% CI: 1.0, 8.4) and non-Hispanic PPOC (6.0%pt; 95% CI: 0.8, 11.2).Experiences of EUR are associated with an increased prevalence of PPD symptoms. Additional prospective research spanning the pre-pregnancy through postpartum periods is needed to examine the dynamic relationship between racism, symptomology, help-seeking, and diagnosis of depression.

Evaluating the Importance of Immediate Postpartum Depression Screening [A269

INTRODUCTION: Postpartum depression (PPD) is costly for women, families, and the health care system. Early identification is critical. We sought to evaluate PPD screening at delivery discharge and compare ongoing rates of positive screening among women at risk of PPD. METHODS: In September 2020, we implemented universal Edinburgh Postpartum Depression Scale (EPDS) screening postpartum (PP) prior to discharge. A score of 9–12 and&gt;12 was moderate and high risk for PPD, respectively. All who scored≥9 met with social workers and were referred for outpatient resources. From September to December 2020, women who scored≥9 were contacted for re-screening at 1–3 weeks PP and at 6-weeks PP visit. RESULTS: A total of 1,256 women underwent immediate PPD screening. Of those, 165 (13.1%) scored ≥9, with 63 (5.0%) of these scoring &gt;12. Two percent (n=24) indicated thoughts of self-harm. Over 50% (n=80) had no prior history of mental illness. Among women who scored≥9 immediately PP and were reached for re-screening, 58 of 111 (52.5%) scored ≥9 within 3 weeks and 48 of 93 (51.6%) scored ≥9 at their PP visit. Among women who scored&gt;12 immediately PP, 32 of 42 (76.2%) scored ≥9 at 3 weeks and 24 of 31 (77.4%) scored ≥9 at their PP visit. Only 41 (24.8%) had initiated therapy by their PP visit. CONCLUSION: Immediate PP EPDS screening is feasible and captures women at risk of PPD. More than half of women who had an elevated score immediately PP continued to score high at their PP visit. Timely screening and access to mental health services is critical and should be integrated into PP care.

After Childbirth: Better Data Can Help Align Postpartum Needs with a New Standard of Care.

After Childbirth: Better Data Can Help Align Postpartum Needs with a New Standard of Care.

Why is it so hard to do the right thing? Reflections on the fourth trimester

Why is it so hard to do the right thing? Reflections on the fourth trimester

Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis.

To compare the predictive validity of the Edinburgh Postnatal Depression Scale (EPDS) and other tools for screening depression in pregnant and postpartum women through a systematic review and meta-analysis. An electronic search of MEDLINE, EMBASE, CINAHL, and PsycArticles databases was conducted using the following keywords: depression, perinatal-related terms, and EPDS. Quality Assessment of Diagnostic Accuracy Studies-2 was used to assess the risk of bias in diagnostic studies. The search identified 823 articles, of which 17 studies met the inclusion criteria. In 1831 pregnant women from nine studies, pooled sensitivity and specificity of the EPDS were 0.81 and 0.87, respectively, with summary receiver operating characteristic (sROC) curve of 0.90. In 515 postpartum women from six studies, pooled sensitivity, specificity, and sROC were 0.79, 0.92, and 0.90, respectively. We then compared the EPDS with other tools using three or more studies. The sROC curve of the Patient Health Questionnaire-9 was 0.74, which was lower than that (0.86) of the EPDS. The sROC curve of the Beck Depression Inventory and the ten-item Kessler Psychological Distress Scale was 0.91, similar to that of the EPDS (0.90 and 0.87). However, in comparison with the Postpartum Depression Screening Scale (0.98), the sROC curve of the EPDS was 0.54. As a tool specialized for screening depression in pregnant and postpartum women, the EPDS showed excellent performance. Thus, the EPDS can be used in preference to other tools to screen for depression in perinatal women at a primary care setting or a midwifery center.

SCREENING FOR POST-PARTUM DEPRESSION USING EDINBURGH SCALE IN A TERTIARY CARE CENTRE.

AIM:To determine the need to screen post-partum women for post-partum depression using 10 item-EPDS score. OBJECTIVE: To determine the prevalence of an Edinburgh Postnatal Depression Scale(EPDS) score of ≥ 13 in postpartum women and to evaluate the association of different sociodemographic and obstetric factors with post-partum depression. MATERIAL AND METHODS : All females delivered at Sharda hospital during the study period of 90 days were recruited for the research after looking for exclusion criteria and obtaining written and informed consent. They were screened using 10 item EPDS score questionnaire and score was given accordingly after third postpartum day. STUDY DESIGN : Prospective observational study. RESULTS : Prevalence in our study population was found to be in the range that is seen across the globe. Most of the women with EPDS score of ≥ 13 belonged to age group of 20-35 years, were from urban sectors, had female child and delivered by caesarean section. Intra-uetrine death and preeeclampsia were among high risk factors which had signicant association with post-partum depression. CONCLUSION: Routine screening for post-partum depression has signicant impact on improving mental health of postpartum females by early diagnosis and prompt treatment of any underlying psychiatric illness.. This improves the postpartum health of a female and ultimately helps to improve the infants well-being.

The impact on postpartum care by telehealth: a retrospective cohort study

During the COVID-19 pandemic, our institution turned to telehealth as the primary method of postpartum care delivery. We aimed to determine the impact of telehealth on completion of postpartum care goals. In a single-center retrospective cohort study, we compared a 14-week period, March to June 2019, before implementation of telehealth, with the same calendar months after implementation during 2020. Patients with a postpartum visit scheduled at our institution during the study period were included. To demonstrate a 10% difference in attendance to the postpartum visit in the postimplementation compared with the preimplementation group, a power analysis calculation resulted in a requirement of at least 356 subjects per group. Our primary outcome was attendance to the postpartum visit. Secondary outcomes included completion of postpartum depression screening, contraception selection, breastfeeding status at postpartum visit, completion of 2-hour glucose tolerance test postpartum for those with gestational diabetes mellitus, and cardiology follow-up when recommended. Multivariable logistic regression with backward elimination was used to control for confounders. Of the 1579 patients meeting inclusion criteria, 780 were in the preimplementation group and 799 in the postimplementation group. Subjects in the postimplementation group were at 90% increased odds of attending a postpartum visit compared with those in the preimplementation group, even when controlling for race, prenatal care provider, parity, gestational age at delivery, and insurance status (82.9% vs 72.4%; P<.001; adjusted odds ratio, 1.90; 95% confidence interval, 1.47-2.46). Patients in the postimplementation group were also more likely to be screened for postpartum depression (86.3% vs 65.1%; P<.001). Although subjects in both groups were equally likely to choose contraception, those in the postimplementation group were less likely to select long-acting reversible contraception or permanent sterilization (26.2% vs 33.2%; P=.03). There was no significant difference in breastfeeding status, postpartum 2-hour glucose tolerance test completion, or cardiology follow-up between groups. Availability of telehealth during the COVID-19 pandemic is associated with increased postpartum visit attendance and postpartum depression screening. However, telehealth was also associated with a decrease in use of long-acting reversible contraception or permanent sterilization.

Multilingual Postpartum Depression Screening in Pediatric Community Health Clinics

This evidence-based practice project established postpartum depression (PPD) screening and followed maternal use of mental health services in a multilingual low socioeconomic status urban population. The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care was used to establish a screening protocol for mothers at their infants' well-child checks. For mothers with positive screens, providers referred them to mental health care and updated their child's electronic health record diagnosis to prompt reassessment for future visits. Over 6 months, 273 mothers were screened at 523 eligible office visits (83.5% screening rate), 26 (9.5%) screened positive, 19 (73.1%) were referred to mental health services, and 12 (63.2%) attended the referral. Thirteen (50%) mothers with PPD had the appropriate electronic health record flag in their infant's record. This project successfully implemented the American Academy of Pediatrics PPD screening guidelines and could be applicable to other pediatric outpatient settings.

The economic toll of COVID‐19: A cohort study of prevalence and economic factors associated with postpartum depression in Kenya

ObjectiveThe aim of the study is to examine the risk of postpartum depression (PPD) among women who delivered during the COVID‐19 pandemic compared to women who delivered before the COVID‐19 pandemic and how economic challenges are associated with PPD.MethodsData were collected from 2332 women. This includes 1197 women from healthcare facilities in 2019 who were followed up at 2–4 and 10 weeks postpartum. Additionally, we recruited 1135 women who delivered from March 16, 2020 onward when COVID‐19 restrictions were mandated in Kenya in the same catchment areas as the original sample to compare PPD rates.ResultsAdjusting for covariates, women who delivered during COVID‐19 had 2.5 times higher odds of screening positive for PPD than women who delivered before COVID‐19 (95% confidence interval [CI] 1.92–3.15). Women who reported household food insecurity, required to pay a fee to cover the cost of PPE during labor and delivery and/or postnatal visit(s), and those who reported COVID‐19 employment‐related impacts had a higher likelihood of screening for PPD compared to those who did not report these experiences.ConclusionThe COVID‐19 pandemic has greatly increased the economic vulnerability of women, resulting in increases in PPD.

Postpartum Depressive Symptoms and Experiences During COVID-19.

Purpose:To identify postpartum depression risk and describe experiences of women in the first 6 weeks after giving birth during the COVID-19 pandemic.Study Design and Methods:Using a convergent mixed-methods approach, we recruited a convenience sample of women living in the United States who gave birth March 1, 2020 or later from social media Web sites. Participants completed the Postpartum Depression Screening Scale-Short Form and provided written answers to open-ended questions regarding their experiences at home with their new infant.Results:Our 262 participants were on average 32.6 years of age, the majority were White (82%), married or partnered (91.9%), and college educated (87.4%). Mean postpartum depression score was 17.7 (SD = 5.9) with 75% scoring ≥14, indicating significant postpartum depressive symptoms. Qualitative content analysis revealed five themes: Isolation and seclusion continue; Fear, anxiety, and stress filled the days; Grieving the loss of normal: It's just so sad; Complicated by postpartum depression: A dark time; and There is a silver lining. Quantitative and qualitative findings provided a holistic view of women's depressive symptoms and experiences at home with their infants during the COVID-19 pandemic.Clinical Implications:Although policies that reduce risk of COVID-19 exposure and infection for patients and the health care team must continue to be implemented, the adverse effects of depressive symptoms on maternal–infant wellbeing within the context of increased isolation due to the pandemic need to be kept at the forefront. Nurses need to be aware of the consequences of women sheltering in place and social distancing on maternal–infant outcomes, particularly on depression and likelihood of breastfeeding.

Prevalence and risk factors of postpartum depression in sub-Himalayan region

BackgroundPostpartum depression (PPD) is a common problem faced by women after childbirth. The adverse effects of PPD upon the maternal-infant relationship and child development reinforce the need for early identification and effective treatment models. This study intends to add to the existing knowledge about the prevalence of PPD and its associated risk factors in the hilly region in Himachal Pradesh. MethodsA hospital-based cross-sectional study was conducted on 426 women presenting for a postpartum visit at 6 weeks postpartum. Sociodemographic characteristics were recorded on a pretested questionnaire. Women were screened for postpartum depression using a validated EPDS (Edinburgh postnatal depression scale) prestructured questionnaire with 10 questions. Women were divided into two groups based on screening results. ResultsThe overall prevalence of PPD in the study was 17.4%. Out of sociodemographic factors, age (0.010) and family structure (0.008) were found to be significant. Nuclear family women were more prone to PPD. Domestic abuse (<0.001) is also a leading factor for PPD. By comparing obstetric and gender issues, it was found that the total number of previous living children (p-value <0.001), gender of previous living children (<0.001), and gender of newborns (<0.001) are the major determining factors of PPD. Another factor that was significantly related to PPD was an unwanted pregnancy. ConclusionsWe have found a high prevalence of PPD in our region that does not have screening protocols for the screening of such patients. We, therefore, propose routine screening for postpartum depression at 6 weeks postpartum.

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Implementing an inpatient postpartum depression screening, education, and referral program: a quality improvement initiative

Perinatal mood and anxiety disorders are common and may interfere with pregnancy, delivery, and the postpartum period. Best practice includes symptom screening, patient education, and appropriate referrals; however, many hospitals struggle to identify and support perinatal mood and anxiety disorders patients. Therefore, the Cedars-Sinai Postpartum Depression Screening, Education and Referral Program was initiated and evaluated. Using the Standards for QUality Improvement Reporting Excellence 2.0 guidelines, we reported outcomes (N=19,564 deliveries) from 4 interventions: (1) nurse-champion training; (2) use of the 9-item Patient Health Questionnaire-9 in the postpartum unit; (3) a series of brief in-service trainings; and (4) a 10-minute video training. We collected data including nurse feedback, screening rates, screen-positive rates, and social work consultation rates. The 4 interventions increased: (1) nurse-champion screening comfort and perinatal mood and anxiety disorder knowledge; (2) Patient Health Questionnaire-9 screening rates from 10% to 99% and screen-positive rates from 0.04% to 2.9%; and (3) rates of social work consultation from 1.7% to 8.4%. Quality improvement results from the first 3 years of the program suggest that 4 interventions improved screening rates, screen-positive rates, and social work consultation rates. Future work will focus on method of screening, patients at highest risk of perinatal mood and anxiety disorders, and ongoing nurse training.

The Relationship Between Neonatal Surgery, Postpartum Depression, and Infant Clinical Course.

Postpartum depression (PPD) affects 10-15% of mothers in the general population, and studies show increased incidence for mothers of infants with serious health conditions. This study investigates incidence of PPD in mothers of surgical patients in the neonatal intensive care unit (NICU) and characterizes these patients' clinical and neurodevelopmental outcomes. This retrospective cohort study analyzed Nebraska's Tracking Infant Progress Statewide (TIPS) database and referring hospital medical records from February 2013 to June 2018. Upon NICU discharge, children were referred to the TIPS program, with scheduled follow-up appointments at approximately 6months corrected age. All patients seen in NICU follow-up clinic with recorded scores for maternal Edinburgh postnatal depression screen (EPDS) were eligible except infants with congenital heart disease as this cohort was previously studied. Patients were stratified into groups based on presence or absence of a general surgical procedure within the first 6 months of life and positive (≥ 10) or negative (< 10) EPDS score. Statistical analyses assessed for significant differences between groups regarding gestational age, birth weight, maternal age, length of NICU stay (LOS), number of days on a ventilator, payment method, ethnicity, developmental testing, and rate of referral for early intervention services. Of 436 patients, 83 were surgical patients (16 with positive EPDS; 19.3% incidence), and 353 were non-surgical patients (44 with positive EPDS; 12.5% incidence). Statistical analysis showed no significant relationship between neonatal surgery and positive EPDS (χ2 = 2.6, p = 0.1). While the surgical cohort had longer LOS and days on ventilator, maternal EPDS did not predict these factors. In the surgical cohort, mothers of children not independent on oral feeding at discharge were more likely to screen positive for depression (7/14, 50% vs. 7/61, 11%; p < 0.05). Mothers of surgical patients are not significantly more likely to screen positive for post-partum depression compared to other NICU mothers. This underscores the importance of routine screening for PPD in mothers of both surgical and non-surgical NICU patients in order to identify parents and children at risk.