Association between antenatal screening for depressive symptoms and postpartum psychiatric admissions

• Published in: Journal of psychiatric research 2021-01, Vol.133, p.46-51
• Main Authors: San Martin Porter, Macarena A., Kisely, Steve, Betts, Kim S., Salom, Caroline, Alati, Rosa
• Format: Article
• Language: English
• Subjects: Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - epidemiology; Depression, Postpartum - diagnosis; Depression, Postpartum - epidemiology; EPDS; Female; Humans; Mass Screening; Postpartum Period; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Prenatal; Prenatal Diagnosis; Psychiatric admissions; Psychiatric Status Rating Scales; Queensland; Retrospective Studies; Risk Factors; Screening
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2020.12.008

Antenatal depression is the strongest predictor for postpartum depression including psychiatric admission. Universal screening for depressive symptoms during pregnancy may increase the detection of clinical depression and reduce consequent morbidity. We therefore hypothesised that antenatal screening for depressive symptoms could reduce the risk of postpartum psychiatric admissions. We explored the association between antenatal depression screening and postpartum psychiatric admissions using cross-sectional retrospective analysis of state-wide population-based health services administrative data. The analysis included all pregnant women who gave birth to a singleton in Queensland in the second half of 2015 and had information in variables of interest (28,255 women; 95.6% of 29,543 women who gave birth to a singleton during the study period). Women who did not complete antenatal depression screening had increased odds of being admitted to hospital for psychiatric disorders during the first three months after birth (aOR, 2.57; 95% CI, 1.69–3.92), which extended to six months postpartum (aOR, 1.74; 95% CI, 1.10–2.76). We found similar effects for specific psychiatric disorder groups such as mood disorders; schizophrenia, schizotypal and delusional disorders; and mental disorders associated with the puerperium (aOR, 2.65; 95% CI, 1.55–4.54) and mood disorders and puerperal mental disorders (aOR, 3.00; 95% CI, 1.70–5.30). Completion of antenatal depression screening appears to be associated with a decreased risk of psychiatric admission in the first postnatal months. This finding suggests that screening, and associated follow-up interventions, might decrease the severity of depressive symptoms during the perinatal period.