Moms' Depression Risk May Flare a Year After Giving Birth

Diedtra Henderson

May 22, 2015

Repeating postpartum depression (PPD) screening at 6 and 12 months after childbirth revealed that 13.5% of women were newly at high risk for depression compared with their status when screened immediately after giving birth, according to a new study.

Barbara P. Yawn, MD, from the Olmsted Medical Center Department of Research, Rochester, Minnesota, and colleagues report the findings in an article published in the May/June issue of the Annals of Family Medicine.

Although clinical practice guidelines exist for many other maternity-related topics, Dr Yawn and coauthors note there is little evidence-based guidance regarding routine PPD screening for women. The authors tapped data from the Translating Research Into Practice for Postpartum Depression study, a large, randomized pragmatic trial that enrolled 2354 women in 16 states who received maternity or early well-child care. Of those, 1432 women had scores that were not elevated postpartum and were eligible to receive surveys again 6 and 12 months after giving birth.

"Together the 6- and 12-month repeated screenings yielded 193 women with elevated [Patient Health Questionnaire] scores who had scores of less than 10 on all prior postpartum assessments," Dr Yawn and colleagues write. "In aggregate the 6- and 12-month screenings identified 13.5% of the 1,432 women eligible for rescreening as being at high risk of having postpartum depression."

Women were more likely to have newly elevated scores if they had a history of depression, were single, had not completed high school, and were anxious. Baseline depressive symptoms, the authors write, are "not useful for predicting later elevated levels."

The authors caution that their results rely on PPD screening, rather than a clinically confirmed diagnosis of PPD. In addition, as women with lower income and less education were less likely to return the questionnaires, the depression risk on rescreening may be underestimated.

"For clinics that have an on-site PPD management program in place, repeated PPD screening during the first postpartum year should be considered based on these results," the authors conclude.

The Agency for HealthCare Research and Quality provided financial support for the study. The authors have disclosed no relevant financial relationships.

Ann Fam Med. 2015;13:228-234. Full text


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