Postpartum Depression Assessments at Well-Baby Visits: Screening Feasibility, Prevalence, and Risk Factors

Freeman, Marlene P.; Wright, Ron; Watchman, Marcy; Wahl, Richard A.; Sisk, Doris J; Fraleigh, Lisa A.; Weibrecht, Josette M.

doi:10.1089/jwh.2005.14.929

Cited by 56 publications

(38 citation statements)

References 16 publications

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“…In this cross-sectional study, we surveyed a convenience sample of mothers 13 years of age and older accompanying their children to well-child visits at 12 months of age (range, 10-14) and 24 months of age (range, [22][23][24][25][26]. Questionnaires were administered at 12 US family medicine academic practices participating in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network, a perinatal collaborative quality initiative of family medicine residency programs in the eastern United States 25 (Supplemental Appendix 1 and Supplemental Appendix 2, available at http://annfammed.org/content/14/4/350/suppl/DC1).…”

Section: Methodsmentioning

confidence: 99%

“…[20][21][22] Pilot studies have shown incorporation of maternal assessment into these visits to be achievable. 23 The purpose of this study was to investigate ICC practices by family physicians at well-child visits. We focused on maternal depression, tobacco use, folic acid supplementation, and family planning because of the strength of evidence for addressing these factors when aiming to reduce poor birth outcomes.…”

mentioning

confidence: 99%

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Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Rosener

Barr

Frayne

et al. 2016

The Annals of Family Medicine

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PURPOSE Interconception care (ICC) is recommended to improve birth outcomes by targeting maternal risk factors, but little is known about its implementation. We evaluated the frequency and nature of ICC delivered to mothers at well-child visits and maternal receptivity to these practices. METHODSWe surveyed a convenience sample of mothers accompanying their child to well-child visits at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network. Health history, behaviors, and the frequency of the child's physician addressing maternal depression, tobacco use, family planning, and folic acid supplementation were assessed, along with maternal receptivity to advice.RESULTS Three-quarters of the 658 respondents shared a medical home with their child. Overall, 17% of respondents reported a previous preterm birth, 19% reported a history of depression, 25% were smoking, 26% were not using contraception, and 58% were not taking folic acid. Regarding advice, 80% of mothers who smoked were counseled to quit, 59% reported depression screening, 71% discussed contraception, and 44% discussed folic acid. Screening for depression and family planning was more likely when the mother and child shared a medical home (P <.05). Most mothers, nearly 95%, were willing to accept health advice from their child's physician regardless of whether a medical home was shared (P >.05).CONCLUSIONS Family physicians provide key elements of ICC at well-child visits, and mothers are highly receptive to advice from their child's physician even if they receive primary care elsewhere. Routine integration of ICC at these visits may provide an opportunity to reduce maternal risk factors for adverse subsequent birth outcomes. 2016;14:350-355. doi: 10.1370/afm.1933. Ann Fam Med INTRODUCTIONI nterconception care (ICC) is defined as care provided to mothers between pregnancies to improve health outcomes for women, newborns, and children.1 It includes interventions that modify risk factors in order to promote healthy outcomes of subsequent pregnancies.2 In 2006, the Centers for Disease Control and Prevention Work Group and Select Panel on Preconception Care recommended risk assessment and intervention in the interconception period, especially for women with previous adverse birth outcomes.3 ICC recommendations regarding maternal depression, tobacco use, folic acid supplementation, and family planning are supported by evidence suggesting that addressing these factors reduces poor birth outcomes. [4][5][6][7][8][9][10][11][12][13][14] ICC has been broadly advocated but not widely implemented. 15,16 Barriers include limited access to health care between pregnancies, maternal focus on their infant to the exclusion of their own personal health needs, 351inadequate knowledge of ICC among clinicians, and lack of an established ICC model. Continuity of care with the same primary care clinician or practice over time has been associated with improved ou...

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Rosener

Barr

Frayne

et al. 2016

The Annals of Family Medicine

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“…Studies of postpartum depression screening demonstrate that it is feasible in outpatient clinical settings, either during mothers' postpartum visits 7,8 or during infants' well-child visits, [9][10][11] with the use of screens such as the Edinburgh Postnatal Depression Scale [7][8][9][10] or the 2-item Patient Health Questionnaire (PHQ-2). 11 In 2 recent studies in which maternal depression screening was performed during well-child visits conducted in pediatric offi ces, mothers' response rates were 55% to 74%.…”

Section: S Cr Eening F or P Os T Pa R T U M Depr Es Sionmentioning

confidence: 99%

Postpartum Depression Screening at Well-Child Visits: Validity of a 2-Question Screen and the PHQ-9

Gjerdingen¹,

Crow²,

McGovern³

et al. 2009

The Annals of Family Medicine

196

149

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PURPOSE Postpartum depression affects up to 22% of women who have recently given birth. Most mothers are not screened for this condition, and an ideal screening tool has not been identifi ed. This study investigated (1) the validity of a 2-question screen and the 9-item Patient Health Questionnaire (PHQ-9) for identifying postpartum depression and (2) the feasibility of screening for postpartum depression during well-child visits.METHODS Study participants were English-literate mothers registering their 0-to 1-month-old infants for well-child visits at 7 family medicine or pediatric clinics. They were asked to complete questionnaires during well-child visits at 0 to 1, 2, 4, 6, and 9 months postpartum. Each questionnaire included 2 depression screens: the 2-question screen and the PHQ-9. The mothers also completed the depression component of the Structured Clinical Interview for DSM-IV (SCID) initially, and again at a subsequent interval if either screening result was positive for depression. RESULTSThe response rate was 33%. Of the 506 women who participated, 45 (8.9%) had major depression (ie, they had a positive result on the SCID). The screen sensitivities/specifi cities over the course of the study were 100%/44% with the 2-question screen, 82%/84% with the PHQ-9 using simple scoring, and 67%/92% with the PHQ-9 using complex scoring. In addition, the corresponding values for the fi rst 2 items of the PHQ-9 (ie, the 2-item Patient Health Questionnaire or PHQ-2) were 84%/79%. Some 38% of women completed their 2-to 6-month questionnaires during well-child visits; the rest completed them by mail (29%) or telephone (33%). CONCLUSIONSThe 2-question screen was highly sensitive and the PHQ-9 was highly specifi c for identifying postpartum depression. These results suggest the value of a 2-stage procedure for screening for postpartum depression, whereby a 2-question screen that is positive for depression is followed by a PHQ-9. These screens can be easily administered in primary care clinics; feasibility of screening during well-child visits was moderate but may be better in clinics using a massscreening approach. INTRODUCTIONP ostpartum depression is increasingly recognized as a unique and serious complication of childbirth, with an estimated prevalence in the 12-month postpartum period of up to 21.9%.1 Mothers' depressive symptoms-diminished mood, pleasure, energy, concentration, and self-worth; psychomotor retardation; changes in appetite and sleep; and suicidal ideation-can markedly impair their sense of well-being, marital and other key relationships, 2 work performance and productivity, 3 relationships with their infants, 4 and infants' behavioral and cognitive development. 5 Recognizing the seriousness of this disorder, the US Preventive S CR EENING F OR P OS T PA R T U M DEPR ES SIONServices Task Force has recommended routine depression screening for adults in practices that have systems in place to ensure accurate diagnosis, effective treatment, and follow-up. 6 Most primary care practices do not h...

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“…The public health nurses in the study by Glavin et al (2010c) described the EPDS as being easy for the mothers to complete and for the nurses to score. Other studies using the EPDS as a screening instrument postpartum also found that EPDS is simple and easy to use for health care workers and mothers (Freeman et al, 2005;Georgiopoulos et al, 1999;Seeley et al, 1996). Krantz et al (2008) argued that routine EPDS screening of postpartum women would lead to considerable ethical problems due to the weak scientific foundation of the screening instrument.…”

Section: The Edinburgh Postnatal Depression Scalementioning

confidence: 97%

“…Public health nurses reported that the parents provided positive reports about the screening procedure (Glavin et al, 2010c). Several studies support the acceptability of the EPDS for mothers when it is used appropriately (Freeman et al, 2005;Georgiopoulos et al, 1999;Milgrom et al, 2005;Poole et al, 2006;Segre et al, 2010).…”

Section: The Edinburgh Postnatal Depression Scalementioning

confidence: 98%

Screening and Prevention of Postnatal Depression

Glavin¹

2012

Perinatal Depression

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Postpartum Depression Assessments at Well-Baby Visits: Screening Feasibility, Prevalence, and Risk Factors

Abstract: We conclude that screening for mothers at well-baby visits is feasible and that the data collected are of sufficient quality to identify reliable predictors even with small sample sizes.

Cited by 56 publications

References 16 publications

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Postpartum Depression Screening at Well-Child Visits: Validity of a 2-Question Screen and the PHQ-9

Screening and Prevention of Postnatal Depression

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