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

Background: 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. Methods: 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. Results: 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. Conclusions: 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.