Prenatal depression screening with postpartum follow-up in an integrated healthcare system identifies risks for positive screens and persistent depressive symptoms

Untreated peripartum depression is associated with adverse neonatal and maternal outcomes. The goal of this study was to identify risks for prenatal depression and persistent symptomatology after delivery. Pregnancies with an Edinburgh Postnatal Depression Scale (EPDS) screening completed at both obstetrics and pediatrics between November 2016 and October 2019 were analyzed (n = 3240). Descriptive and inferential statistical methods were conducted. Black women were more likely to screen positive prenatally (OR 2.42, p<0.001). Single women had more thoughts of self-harm (OR=2.42, p<0.05). Over a third of women screened positive during pregnancy and postpartum. These ‘persistent positives’ were more likely to have higher prenatal EPDS scores (p = 0.02) compared to positive screens that appeared to resolve postpartum. For Black women and those with thoughts of self-harm or high EPDS scores prenatally, there needs to be more timely treatment and/or increased referral to psychiatric services by primary care.