Article Figures & Data
Figures
- Figure 1
Results of repeated administration of PHQ-9 during the first postpartum year.
PHQ-9 = 9-item Patient Health Questionnaire; PP = postpartum.
Note: shading indicates newly elevated PHQ-9 scores at 6 and 12 months’ postpartum.
aPHQ-9 score was <10.
bPHQ-9 score was ≥10.
Tables
- Table 1
Demographic Characteristics of Women Eligible for Repeated Postpartum Depression Screening
Characteristic All Women (n = 1,432) Became ≥10a (n = 193) Remained <10b (n = 910) Unknown (n = 329) P Valuec Age, mean, y 26.7 25.8 27.3 25.8 <.001 Married, No. (%) 824 (57.5) 89 (46.1) 594 (65.3) 141 (42.9) <.001 Living with partner, No. (%) 1,117 (78.0) 141 (73.1) 738 (81.1) 238 (72.3) .02 ≥1 More adult in household, No. (%) 1,276 (89.1) 164 (85.0) 837 (92.0) 275 (83.6) .004 Race, No. (%) Black 243 (17.0) 33 (17.1) 133 (14.6) 77 (23.4) NS White, not Hispanic 889 (62.1) 124 (64.2) 613 (67.4) 152 (46.2) NS Ethnicity Hispanic 227 (15.9) 25 (13.0) 122 (13.4) 80 (24.3) NS Employed, No. (%) 722 (50.4) 106 (54.9) 457 (50.2) 159 (48.3) NS >High school, No. (%) 781 (54.5) 96 (49.7) 540 (59.3) 145 (44.1) .02 Income, No. (%) >$50,000 305 (21.3) 33 (17.1) 230 (25.3) 42 (12.8) .02 <$20,000 540 (37.7) 88 (45.6) 285 (31.3) 167 (50.8) <.001 Primiparous, No. (% 484 (33.8) 58 (30.1) 322 (35.4) 104 (31.6) NS History of depression, No. (%) 373 (26.0) 87 (45.1) 202 (22.2) 84 (25.5) <.001 Uninsured anytime in 1st postpartum year, No. (%) 404 (28.2) 55 (28.5) 269 (29.6) 80 (24.3) NS Anxiety by EPDS questions 3,4,5, No. (%) 125 (8.7) 36 (18.7) 56 (6.2) 33 (10.0) <.001 -
EPDS = Edinburgh Postnatal Depression Scale; NS = nonsignificant at P ≥.05; PHQ-9 = 9-item Patient Health Questionnaire.
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Note: Eligible women were those enrolled in the study who returned baseline PHQ-9 scores of less than 10.
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↵a Woman whose PHQ-9 scores became elevated at 6 or 12 months.
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↵b Women whose PHQ-9 scores remained below 10 at 6 and 12 months.
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↵c χ2 Tests were used to compare frequencies; t test was used for age.
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Predictor P Value OR (95% CI) PHQ-9 >1 at baseline <. 001 6.7 (3.7, 12.2) History of depression <. 001 2.2 (1.6, 3.0) Not married .04 1.4 (1.0, 2.0) <High school graduate .007 1.8 (1.2, 2.7) EPDS anxiety score ≥6 .002 2.0 (1.3, 3.0) -
EPDS = Edinburgh Postnatal Depression Scale; PHQ-9 = 9-item Patient Health Questionnaire
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Note: Generalized linear mixed-effects model predicting high PHQ-9 scores at either 6 months or 12 months’ postpartum, after a baseline PHQ-9 score<10.
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The Article in Brief
Repeated Depression Screening During the First Postpartum Year
Barbara P. Yawn , and colleagues
Background Postpartum depression (PPD) is common, costly, and associated with adverse outcomes for mothers, infants and families. No studies, however, have evaluated the impact or outcomes related to repeated PPD screening. This study examined the benefit of repeated screening for PPD at 6 and 12 months postpartum.
What This Study Found Fourteen percent of new mothers who initially screen negative for postpartum depression end up developing depressive symptoms during the first postpartum year. In this study, 11 percent of women who did not initially have elevated depression screening scores had elevated scores at six months. Further, at 12 months, scores were elevated for seven percent of women who previously did not have elevated scores. Together, the six- and 12-month repeated screenings identified 14 percent of the women whose screening results were initially negative for PPD.
Implications
- Rescreening can identify an additional group of women appropriate for careful clinical evaluation of PPD and who may be candidates for depression. The authors call for future research to understand the impact of repeated PPD screening on patient outcomes.
