(956) Does increased antenatal depression screening impact postpartum depression scale scores?

With mental health disorders a leading cause of maternal mortality, perinatal mental health screening and care is a strategy for prevention. The use of a validated screening tool, including the Edinburgh Postnatal Depression Scale (EPDS) has been recommended, but the optimal timing for screening and the impact of repeated screening has yet to be established. This study aimed to assess whether prenatal screening and identification of depression impacted postpartum EPDS scores.


Study Design:

In this retrospective single site study, pregnant persons who enrolled in prenatal care prior to 20w gestation and delivered at the same institution from 2018-2024 were included (N=6,735). EPDS screening was performed at postpartum visits only until 2023 when EPDS was given at entry to care, during the third trimester, while inpatient postpartum and at postpartum visits. A score of >12 was considered positive for depression. Prenatal screening, socio-demographic profiles, and PPD prevalence were analyzed pre/post implementation using t-tests, chi-square tests, and multiple variable logistic regression.


Results:

Overall, 57.8% of patients delivered prior to the expanded EPDS implementation. The mean age at delivery was 28.5±6.0 years, 46.6% identified as White, 39.6% as Black, and 18.2% were Hispanic. Prior to implementation, 12.7% of all patients had a high postpartum EPDS score compared to 7.4% after (p< 0.001). Adjusting for demographic factors, patients who delivered after the implementation were less likely to have a high postpartum EPDS score (OR: 0.21, 95%CI: 0.19-0.24, p-value< 0.001). This association remained after accounting for additional screening (OR: 0.29, 95%CI: 0.26-0.33, p-value< 0.001).


 

Conclusion:

Serial antenatal depression screening was associated with lower postpartum EPDS scores. Future investigation will examine the relationship between pre-existing mental health disease, prenatal identification, and referral on postpartum depression screening patterns.