Who do we miss when screening for postpartum depression? A population-based study in a Swedish region.
Edinburgh postnatal depression scale
Postpartum depression
Screening tools
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
15 05 2021
15 05 2021
Historique:
received:
13
11
2020
revised:
04
03
2021
accepted:
08
03
2021
pubmed:
3
4
2021
medline:
22
5
2021
entrez:
2
4
2021
Statut:
ppublish
Résumé
Universal screening for postpartum depression is crucial for early detection, interventions and support. The aim of this study was to describe the proportion of, and explore risk factors for, women not being offered screening, as well as for declining an offer or not being screened due to any other unknown reason. Socioeconomic, obstetrical and neonatal data, extracted from the Swedish Pregnancy Registry, for 9,959 pregnancies recorded for the Östergötland county between 2016 and 2018 were linked to Edinburgh Postnatal Depression Scale (EPDS) screening results at 6-8 weeks postpartum, extracted from medical records. Risk factors were assessed using logistic regression models and with a nomogram for easy visualization. In total, there were no recorded offers of EPDS screening in the medical records for 30.0% of women at the postpartum follow-up. Women born outside of Sweden and women reporting poor self-rated health were at increased risk of not being offered screening for postpartum depression. There is a possibility that women were offered screening or were screened, but this was incorrectly or never recorded in medical records. The majority of women were offered screening for postpartum depression, but there is room for improvement in order to achieve universal screening. Awareness among healthcare providers of the risk factors for not screening might increase adherence to guidelines for universal screening. Overcoming barriers for screening and raising the topic of mental-health issues for postpartum women should be prioritized.
Sections du résumé
BACKGROUND
Universal screening for postpartum depression is crucial for early detection, interventions and support. The aim of this study was to describe the proportion of, and explore risk factors for, women not being offered screening, as well as for declining an offer or not being screened due to any other unknown reason.
METHODS
Socioeconomic, obstetrical and neonatal data, extracted from the Swedish Pregnancy Registry, for 9,959 pregnancies recorded for the Östergötland county between 2016 and 2018 were linked to Edinburgh Postnatal Depression Scale (EPDS) screening results at 6-8 weeks postpartum, extracted from medical records. Risk factors were assessed using logistic regression models and with a nomogram for easy visualization.
RESULTS
In total, there were no recorded offers of EPDS screening in the medical records for 30.0% of women at the postpartum follow-up. Women born outside of Sweden and women reporting poor self-rated health were at increased risk of not being offered screening for postpartum depression.
LIMITATIONS
There is a possibility that women were offered screening or were screened, but this was incorrectly or never recorded in medical records.
CONCLUSIONS
The majority of women were offered screening for postpartum depression, but there is room for improvement in order to achieve universal screening. Awareness among healthcare providers of the risk factors for not screening might increase adherence to guidelines for universal screening. Overcoming barriers for screening and raising the topic of mental-health issues for postpartum women should be prioritized.
Identifiants
pubmed: 33799034
pii: S0165-0327(21)00238-X
doi: 10.1016/j.jad.2021.03.013
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
165-173Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.