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.