Association between antenatal screening for depressive symptoms and postpartum psychiatric admissions.

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.

Screening for perinatal depression and predictors of underscreening: findings of the Born in Queensland study.

OBJECTIVES: To investigate screening with the Edinburgh Postnatal Depression Scale (EPDS) as part of Queensland prenatal care services, as well as maternal and socio-demographic factors associated with not being screened. DESIGN, SETTING: Cross-sectional retrospective analysis of data from the Queensland population-based Perinatal Data Collection for July 2015 - December 2015. PARTICIPANTS: All women giving birth in Queensland during the second half of 2015. MAIN OUTCOME MEASURES: Screening with the EPDS, with the values "yes" (health professional recorded an EPDS score), "no" (health professional reported it was not performed), and "not stated". RESULTS: Of 30 468 women who gave birth in Queensland, 21 735 (71.3%) completed the EPDS during pregnancy; 18 942 pregnant women were enrolled as public patients (91.0%) and 2762 as private patients (28.8%). After adjusting for other socio-demographic factors, screening was less likely for women who were aged 36 years or more (v 25 years or younger: adjusted odds ratio [OR], 0.69; 95% CI, 0.60-0.79), enrolled as private patients (aOR, 0.05; 95% CI, 0.05-0.06), born overseas (aOR, 0.75; 95% CI, 0.68-0.82), Indigenous Australians (aOR, 0.47; 95% CI, 0.39-0.56), single or separated (aOR, 0.83; 95% CI, 0.73-0.94), or of higher socio-economic status. CONCLUSIONS: Four years after clinical guidelines recommending universal screening with the EPDS were published, screening rates for private and public health care patients differed markedly. Our results may inform future comparisons and analyses of the impact on screening of recent changes to Medicare definitions intended to increase that of women in private health care.