Utilization of Postpartum Depression Screening in the Pediatric Emergency Department

BACKGROUND: Postpartum depression (PPD) is a common complication of childbirth with significant implications for maternal and child health. Standard screening practices may miss mothers with later-onset symptoms. The pediatric emergency department (PED) may provide an opportunity to extend PPD screening beyond routine outpatient care. OBJECTIVES: To evaluate the feasibility and utilization of Edinburgh Postnatal Depression Scale (EPDS) screening for PPD among mothers of children 12 months or younger presenting to a PED and to describe the demographics of screened patients. METHODS: We conducted a retrospective descriptive study of EPDS screening implemented as a quality improvement initiative in an urban academic PED between May 15, 2023 and November 30, 2023. Biological mothers of children 12 months or younger were screened at triage using the EPDS in English or Spanish. Positive screens were defined as a score ≥9 or endorsement of suicidal ideation. Demographic data, Emergency Severity Index (ESI), insurance status, EPDS results, and documented interventions were abstracted from the electronic medical record. RESULTS: A total of 734 EPDS screens were completed. Forty-one mothers (5.6%) screened at risk or positive. Of these, 17 (41%) had infants aged 6 to 12 months. Maternal mental health resources were offered to 37 (90.2%) mothers with positive screens. All mothers with positive screens had public insurance. The screened population was predominantly white (41.1%) and Hispanic (41.1%). CONCLUSIONS: PPD screening in the PED for mothers of children up to 12 months of age is feasible and may identify at-risk mothers. PED-based screening may help address gaps in maternal mental health care for underserved populations.