Comparison of Edinburgh postnatal depression scale scores between high-risk pregnancy and normal pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20261623Keywords:
Edinburgh postnatal depression scale, EPDS, High-risk pregnancy, Perinatal mental health, Postpartum depression, Postpartum screeningAbstract
Background: Postpartum depression (PPD) is a significant perinatal mental health disorder with a reported prevalence of 8-20% globally. Obstetricians serve as the frontline clinicians best positioned to screen for PPD. However, universal screening remains inconsistently implemented in routine clinical practice. This study aimed to compare Edinburgh postnatal depression scale (EPDS) scores between women with high-risk pregnancies and those with normal pregnancies, and to identify specific high-risk subgroups that may warrant targeted screening.
Methods: A prospective analytical study was conducted between January 2020 and July 2021 in the department of obstetrics and gynecology at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. One hundred postpartum women were enrolled. The validated EPDS questionnaire was administered 72 hours post-delivery in a private setting. An EPDS score of ≥9 was used as the positive screening threshold. Statistical analysis employed unpaired t-tests and chi-square tests as appropriate.
Results: Of 100 women screened, 51 (51%) had an EPDS score of ≥9. Four variables were statistically significantly associated with a positive screen: employment status (47.1% employed vs. 18.4% housewife with EPDS≥9; p=0.002), lower gestational age (mean 37.37±3.50 weeks versus 38.46±1.38 weeks; p=0.043), neonatal NICU admission (27.5% versus 4.1%; p=0.001), and delayed breastfeeding initiation (33.3% versus 12.2%; p=0.012). Age, religion, educational status, duration of marriage, parity, mode of delivery, presence of comorbidities, neonatal gender, and birth weight did not demonstrate statistically significant associations.
Conclusions: Employed women, women who delivered preterm, mothers whose neonates required NICU admission, and those with delayed breastfeeding initiation demonstrated significantly higher EPDS scores. These groups should be prioritised for postpartum depression screening in clinical practice.
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References
Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet. 2014;384(9956):1775-88. DOI: https://doi.org/10.1016/S0140-6736(14)61276-9
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th edn. Arlington: APA; 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO; 1992.
Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord. 2015;175:34-52. DOI: https://doi.org/10.1016/j.jad.2014.12.041
Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatr. 2008;65(7):805-15. DOI: https://doi.org/10.1001/archpsyc.65.7.805
O’Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):3-12. DOI: https://doi.org/10.1016/j.bpobgyn.2013.09.002
Gupta S, Kishore J, Mala YM, Ramji S, Aggarwal R. Postpartum depression in north Indian women: prevalence and risk factors. J Obstet Gynecol India. 2013;63(4):223-9. DOI: https://doi.org/10.1007/s13224-013-0399-x
Upadhyay RP, Chowdhury R, Salehi A, Sarkar K, Singh SK, Sinha B, et al. Postpartum depression in India: a systematic review and meta-analysis. Bull World Health Organ. 2017;95(10):706-17C. DOI: https://doi.org/10.2471/BLT.17.192237
Meltzer-Brody S, Maegbaek ML, Medland SE, Miller WC, Sullivan P, Munk-Olsen T. Obstetrical, pregnancy and socio-economic predictors for new-onset severe postpartum psychiatric disorders in primiparous women. Psychol Med. 2017;47(8):1427-41. DOI: https://doi.org/10.1017/S0033291716003020
Fuhr DC, Calvert C, Ronsmans C, Chandra PS, Sikander S, De Silva MJ, et al. Contribution of suicide and injuries to pregnancy-related mortality in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Psychiatr. 2014;1(3):213-25. DOI: https://doi.org/10.1016/S2215-0366(14)70282-2
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatr. 1987;150:782-6. DOI: https://doi.org/10.1192/bjp.150.6.782
Teissèdre F, Chabrol H. Detecting women at risk for postnatal depression using the Edinburgh Postnatal Depression Scale at 2 to 3 days postpartum. Can J Psychiatr. 2004;49(1):51-4. DOI: https://doi.org/10.1177/070674370404900108
Mishra K, Mohapatra I, Rout RN. An epidemiological study on depression among women during postpartum period in an urban slum of Bhubaneswar. J Fam Med Prim Care. 2020;9(9):4736-40. DOI: https://doi.org/10.4103/jfmpc.jfmpc_793_20
Anokye R, Acheampong E, Budu-Ainooson A, Obeng EI, Akwasi AG. Prevalence of postpartum depression and interventions utilized for its management. Ann Gen Psychiatr. 2018;17:18. DOI: https://doi.org/10.1186/s12991-018-0188-0
Ni Q, Cheng G, Chen A, Heinonen S. Early detection of mental illness for women suffering high-risk pregnancies: an explorative study on self-perceived burden during pregnancy and early postpartum depressive symptoms among Chinese women hospitalised with threatened preterm labour. BMC Psychiatr. 2020;20(1):250. DOI: https://doi.org/10.1186/s12888-020-02667-0
Katon W, Russo J, Gavin A. Predictors of postpartum depression. J Womens Health. 2014;23(9):753-9. DOI: https://doi.org/10.1089/jwh.2014.4824
Ihongbe TO, Masho SW. Do successive preterm births increase the risk of postpartum depressive symptoms? J Pregnancy. 2017;2017:4148136. DOI: https://doi.org/10.1155/2017/4148136
Bener A. Psychological distress among postpartum mothers of preterm infants and associated factors: a neglected public health problem. Braz J Psychiatr. 2013;35(3):231-6. DOI: https://doi.org/10.1590/1516-4446-2012-0821
El-Hachem C, Rohayem J, Bou Khalil R, Richa S, Kesrouani A, Gemayel R, et al. Early identification of women at risk of postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) in a sample of Lebanese women. BMC Psychiatr. 2014;14:242. DOI: https://doi.org/10.1186/s12888-014-0242-7
Hoedjes M, Berks D, Vogel I, Franx A, Bangma M, Darlington AS, et al. Postpartum depression after mild and severe preeclampsia. J Womens Health. 2011;20(10):1535-42. DOI: https://doi.org/10.1089/jwh.2010.2584
Sheela CN, Venkatesh S. Screening for postnatal depression in a tertiary care hospital. J Obstet Gynaecol India. 2016;66(Suppl 1):72-6. DOI: https://doi.org/10.1007/s13224-015-0766-x
Yahya NFS, Teng NIMF, Shafiee N, Juliana N. Association between breastfeeding attitudes and postpartum depression among mothers with premature infants during COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(20):10915. DOI: https://doi.org/10.3390/ijerph182010915
Ye Y, Chen L, Xu J, Dai Q, Luo X, Shan N, et al. Preeclampsia and its complications exacerbate development of postpartum depression: a retrospective cohort study. Biomed Res Int. 2021;2021:6641510. DOI: https://doi.org/10.1155/2021/6641510
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