Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 40, Issue 2, Pages 194-200Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0041-1727226
Keywords
depression; Edinburgh Postnatal Depression Scale; mood; perinatal; postpartum; screening
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This study evaluated the effectiveness of the Edinburgh Postnatal Depression Scale (EPDS) in the immediate postpartum period and found that it is not a reliable predictor of postpartum depression development during hospitalization shortly after delivery, as determined by the EPDS validated at the 6-week postpartum time interval.
Objective This study was aimed to evaluate the efficacy of the Edinburgh Postnatal Depression Scale (EPDS) in the immediate postpartum period, which we defined as between 3 and 24 hours postpartum for the purpose of this research. This is such that if it can predict scores obtained at the postpartum visit, it will be an opportunity to access psychiatric services for the patient that may otherwise be more difficult to access in the outpatient setting. Study Design Longitudinal observational study, which included an analysis of 848 consecutive participants screened with the EPDS in the hospital and at the 6-week postpartum visit. Results Receiver-operating characteristic (ROC) curve suggested >3 at delivery as a more optimal score to predict depression at the postpartum visit with sensitivity 76.5% and specificity 65.9%. The commonly accepted EPDS cutoff value of >9 was far less sensitive at 28.8% but reasonably specific at 93.2% for predicting elevated scores (>9) 6 weeks postpartum. In subgroup analysis, only a prior mental health disorder was found to be predictive of elevated scores at the postpartum visit (relative risk: 1.97, 95% confidence interval: 1.17-3.32, p = 0.01). Conclusion The EPDS, originally designed to screen for postpartum depression (PPD) in the outpatient setting, does not predict the development of PPD, as determined by the EPDS (validated at the 6-week postpartum time interval) when administered during hospitalization shortly after delivery.
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