Screening for maternal postpartum depression during infant hospitalizations

Margaret J Trost; Kira Molas-Torreblanca; Carol Man; Ernesto Casillas; Hoda Sapir; Sheree M Schrager

doi:10.1002/jhm.2646

Screening for maternal postpartum depression during infant hospitalizations

J Hosp Med. 2016 Dec;11(12):840-846. doi: 10.1002/jhm.2646. Epub 2016 Aug 16.

Authors

Margaret J Trost^{1

2}, Kira Molas-Torreblanca^{1

2}, Carol Man², Ernesto Casillas², Hoda Sapir³, Sheree M Schrager¹

Affiliations

¹ Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California.
² University of Southern California, Keck School of Medicine, Los Angeles, California.
³ Division of Social Work, Children's Hospital Los Angeles, Los Angeles, California.

PMID: 27527537
DOI: 10.1002/jhm.2646

Abstract

Background: Postpartum depression is common and adversely affects children of afflicted mothers; postpartum depression recognition and treatment may improve outcomes. Hospitalization represents a potential health encounter for expanding screening and intervention.

Objective: We aimed to assess for postpartum depression at infant hospitalization and examine postpartum depression risk factors in this population.

Design, setting, and participants: We conducted a prospective observational study of 310 English- or Spanish-speaking women with an infant aged 2 weeks to 1 year admitted to a pediatric hospitalist service at a large urban freestanding children's hospital.

Measurements: Mothers completed demographic questionnaires, a maternal-infant bonding scale, and the Edinburgh Postpartum Depression Scale (EPDS). Mothers with an EPDS score of 10 or higher (positive screen) received counseling and mental health referrals. Postenrollment calls followed trends in EPDS score and resource utilization. Multivariate logistic regression assessed relationships among risk factors and positive screens.

Results: Eighty-seven mothers (28%) were EPDS+. Only 14.6% reported appropriate prior depression screening. Maternal factors associated with EPDS+ were poor social support (4.40, interquartile range [IQR] = 2.27-8.53) and history of psychiatric diagnoses (5.02, IQR = 2.49-10.15). Having an infant with neurodevelopmental comorbidities was associated with EPDS+ screens (2.78, IQR = 1.03-7.52). Of 21 initially EPDS+ mothers reached by phone, 8 (38%) utilized their doctor or referral resource, resulting in lower EPDS scores (F(1,19) = 5.743, P < 0.05) compared to those not seeking help.

Conclusion: Postpartum depression screening during infant hospitalizations captures women previously unscreened. Low social support, past psychiatric diagnoses, or having infants with neurodevelopmental problems may increase postpartum depression risk. Journal of Hospital Medicine 2015;11:840-846. © 2015 Society of Hospital Medicine.

Publication types

Observational Study

MeSH terms

Adult
Depression, Postpartum / psychology*
Female
Hospitalization
Humans
Infant
Infant, Newborn
Mass Screening / methods*
Mother-Child Relations / psychology*
Prospective Studies
Referral and Consultation
Risk Factors
Social Support
Surveys and Questionnaires