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Screening for maternal postpartum depression during infant hospitalizations
Author(s) -
Trost Margaret J.,
MolasTorreblanca Kira,
Man Carol,
Casillas Ernesto,
Sapir Hoda,
Schrager Sheree M.
Publication year - 2016
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2646
Subject(s) - medicine , edinburgh postnatal depression scale , postpartum depression , interquartile range , depression (economics) , population , referral , postpartum period , pregnancy , obstetrics , psychiatry , pediatrics , family medicine , depressive symptoms , anxiety , environmental health , surgery , macroeconomics , biology , economics , genetics
BACKGROUND Postpartum depression is common and adversely affects children of afflicted mothers; postpartum depression recognition and treatment may improve outcomes. Hospitalization represents a potential health encounter for expanding screening and intervention. OBJECTIVE We aimed to assess for postpartum depression at infant hospitalization and examine postpartum depression risk factors in this population. DESIGN, SETTING, AND PARTICIPANTS We conducted a prospective observational study of 310 English‐ or Spanish‐speaking women with an infant aged 2 weeks to 1 year admitted to a pediatric hospitalist service at a large urban freestanding children's hospital. MEASUREMENTS Mothers completed demographic questionnaires, a maternal–infant bonding scale, and the Edinburgh Postpartum Depression Scale (EPDS). Mothers with an EPDS score of 10 or higher (positive screen) received counseling and mental health referrals. Postenrollment calls followed trends in EPDS score and resource utilization. Multivariate logistic regression assessed relationships among risk factors and positive screens. RESULTS Eighty‐seven mothers (28%) were EPDS+. Only 14.6% reported appropriate prior depression screening. Maternal factors associated with EPDS+ were poor social support (4.40, interquartile range [IQR] = 2.27–8.53) and history of psychiatric diagnoses (5.02, IQR = 2.49–10.15). Having an infant with neurodevelopmental comorbidities was associated with EPDS+ screens (2.78, IQR = 1.03–7.52). Of 21 initially EPDS+ mothers reached by phone, 8 (38%) utilized their doctor or referral resource, resulting in lower EPDS scores ( F (1,19) = 5.743, P < 0.05) compared to those not seeking help. CONCLUSION Postpartum depression screening during infant hospitalizations captures women previously unscreened. Low social support, past psychiatric diagnoses, or having infants with neurodevelopmental problems may increase postpartum depression risk. Journal of Hospital Medicine 2015;11:840–846. © 2015 Society of Hospital Medicine