A cross-sectional study of early identification of postpartum depression: Implications for primary care providers from The Ontario Mother & Infant Survey

School of Social Work, McMaster University, Hamilton, ON, Canada.
BMC Family Practice (Impact Factor: 1.67). 04/2002; 3(1):5. DOI: 10.1186/1471-2296-3-5
Source: PubMed


This survey's objective was to provide planning information by examining utilization patterns, health outcomes and costs associated with existing practices in the management of postpartum women and their infants. In particular, this paper looks at a subgroup of women who score >or= 12 on the Edinburgh Postnatal Depression Survey (EPDS).
The design is cross-sectional with follow-up at four weeks after postpartum hospital discharge. Five Ontario hospitals, chosen for their varied size, practice characteristics, and geographic location, provided the setting for the study. The subjects were 875 women who had uncomplicated vaginal deliveries of live singleton infants. The main outcome measures were the EPDS, the Duke UNC Functional Social Support Questionnaire and the Health and Social Services Utilization Questionnaire.
EPDS scores of >or= 12 were found in 4.3 to 15.2% of otherwise healthy women. None of these women were being treated for postpartum depression. Best predictors of an EPDS score of >or= 12 were lack: of confident support, lack of affective support, household income of <20,000 dollars, wanting to stay in hospital longer, identification of learning needs while in hospital, self-identified care needs for an emotional/mental health problem that have not been met and mother's rating of own and baby's health as fair or poor.
Primary care physicians, midwives, and public health nurses need to screen for depression at every opportunity early in the postpartum period. A mother's expression of undue concern about her own or her baby's health may be predictive of postpartum depression. Flexible, mother-focused support from community providers may decrease the prevalence of postpartum depression.

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    • "However, there are no recent studies that show the overall provincial and national prevalence rates of PPD, and the few studies that have been performed show varying results, refer to specific communities that may not be representative of the Canadian population. For example, the prevalence of PPD was found to range from 4.3 to 15.2% in postpartum patients from five Ontario hospitals [16]. Similarly, in a study utilizing the EPDS, Davey et al. (2008) found that 6.5% of a cohort of medically low risk pregnant women in the Calgary Health Region displayed symptoms of minor/major PPD while 4.5% scored in the range of major PPD [6]. "
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    ABSTRACT: This study aims to look at the prevalence and characteristics of postpartum depression symptomatology (PPDS) among Canadian women. Studies have found that in developed countries, 10-15% of new mothers were affected by major postpartum depression. Mothers who suffer from postpartum depression may endure difficulties regarding their ability to cope with life events, as well as negative clinical implications for maternal-infant attachment. An analysis based on 6,421 Canadian women, who had a live birth between 2005 and 2006 and were part of the Maternity Experience Survey (MES), was performed. PPDS was measured based on the Edinburgh Postnatal Depression Scale. Various factors that assessed socio-economic status, demographic factors, and maternal characteristics were considered for the multinomial regression model. The national prevalence of minor/major and major PPDS was found to be 8.46% and 8.69% respectively. A mother's stress level during pregnancy, the availability of support after pregnancy, and a prior diagnosis of depression were the characteristics that had the strongest significant association with the development of PPDS. A significant number of Canadian women experience symptoms of postpartum depression. Findings from this study may be useful to increase both the attainment of treatment and the rate at which it can be obtained among new mothers. Interventions should target those with the greatest risk of experiencing PPDS, specifically immigrant and adolescent mothers.
    Full-text · Article · May 2011 · BMC Public Health
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    • "Standard depression interventions (e.g., cognitive behavioral therapy and interpersonal psychotherapy) are effective with postpartum women (Chabrol et al., 2002; O&apos;Hara, Stuart, Gorman, & Wenzel, 2000); nevertheless, most depressed mothers do not receive care (Watt, Sword, Krueger, & Sheehan, 2002). For example, one study found that for women screened for depression at their prenatal visit, only 13.8% of those identified as possibly depressed were receiving treatment (Marcus, Flynn, Blow, & Barry, 2003). "
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    ABSTRACT: Maternal depression affects approximately one in five women, is undertreated, and compromises infant development. In the United Kingdom, public health nurses provide an empirically supported intervention (Listening Visits [LV]) to depressed postpartum women. This study evaluates the effectiveness of LV when delivered by U.S. home visitors. Nineteen women with depressive symptoms received LV. Pre-, post-, and follow-up assessments evaluated depression status, life satisfaction, and treatment acceptability. Listening Visits were associated with a statistically and clinically significant reduction in depression, improvement in life satisfaction, and were acceptable to this sample of postpartum women. The LV intervention shows considerable promise as an effective and acceptable depression treatment.
    Full-text · Article · Nov 2010 · Psychotherapy Research
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