Depression in pregnancy: time of screening and access to psychiatric care

• Published in: The journal of maternal-fetal & neonatal medicine 2011-11, Vol.24 (11), p.1321-1324
• Main Authors: Burton, Aiyanna, Patel, Sagar, Kaminsky, Lillian, Rosario, Gelen Del, Young, Roseyln, Fitzsimmons, Adriana, Canterino, Joseph C.
• Format: Article
• Language: English
• Subjects: Adult; Cross-Sectional Studies; Depression - diagnosis; Depression - therapy; Depression, Postpartum - diagnosis; Educational Status; Female; Gestational Age; Humans; Infant, Newborn; Postpartum depression; Pregnancy; Pregnancy Complications - psychology; psychiatric care; screening; Time Factors
• ISSN: 1476-7058; 1476-4954
• DOI: 10.3109/14767058.2010.547234

Objective. To determine the timing of screening for postpartum depression that optimizes access to psychiatric care. Methods. Cross-sectional evaluation of women receiving obstetric care in a community-based medical center clinic from March to July 2006, who were screened for depression at 36 weeks gestation, delivery, and 6 weeks postpartum using the Edinburgh Postnatal Depression Scale. Positive screens generated referrals for psychiatric evaluation. The rate of positive screens for depression and psychiatric follow-up at each time point was evaluated. Results. Of the 293 patients evaluated, the distribution of the first screen which occurred during the study period was 21% at 36 weeks, 31% at delivery, and 48% at 6 weeks postpartum. The incidence of a positive screen was 5% at 36 weeks, 16% at delivery and 14% at 6 weeks postpartum. Access to psychiatric care occurred in 33% at 36 weeks, 15% at 6 weeks postpartum and 100% at delivery (p = 0.001). Conclusion. Screening for depression in the hospital after delivery improves access to psychiatric care.