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Identification of antenatal depression in obstetric care

Alder, Judith ; Fink, Nadine ; Urech, Corinne ; Hösli, Irene ; Bitzer, Johannes

In: Archives of Gynecology and Obstetrics, 2011, vol. 284, no. 6, p. 1403-1409

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    Title
    • Identification of antenatal depression in obstetric care
    Author
    • Alder, Judith. University Women's Hospital, University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Fink, Nadine. Children's Hospital, Harvard Medical School, Boston, Hunnewell 2, Rm HU-260.2, 300 Longwood Ave, 02115, Boston, MA, USA
    • Urech, Corinne. University Women's Hospital, University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Hösli, Irene. University Women's Hospital, University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Bitzer, Johannes. University Women's Hospital, University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Archives of Gynecology and Obstetrics, 2011, vol. 284, no. 6, p. 1403-1409. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:318777
    Summary
    Purpose: Detection rates of depression in obstetric care are generally low, and many women remain undiagnosed and do not receive adequate support. In many obstetric settings, screening tools for depression are not applied routinely and there is a great need to sensitize health care professionals for the patient at risk for enhanced levels of depression. The present study aimed at identifying commonly assessed patient characteristics that are associated with antenatal depression. Methods: One hundred and thirty seven women were screened using the Edinburgh Postnatal Depression Scale (EPDS) at the beginning of the second trimester at the outpatient department of a Tertiary University Hospital. Women were identified as at high risk for depression if scores were above a cut-off score of twelve. Obstetric history and outcome were extracted from patient files after delivery. Results: Twenty one percent of the sample screened as depression positive. Logistic regression with backwards elimination showed that the triad of nausea during pregnancy, reports of (premature) contractions and consumption of analgesics during pregnancy significantly predicted high depression scores with a positive predictive value of 84.3%. The relative risk for a depressed pregnant woman to regularly take analgesics during pregnancy was fourfold higher than for non-depressed women. Conclusions: If depression screening is not part of routine prenatal care, systematic assessment of depression should be targeted for patients presenting with the markers identified in this study