Jardri R, Pelta J, Maron M, Thomas P, Delion P, Codaccioni X et al. Predictive validation study of the Edinburgh postnatal depression scale in the first week after delivery and risk analysis for postnatal depression. J Affect Disord 93: 169-176

Hôpital Michel Fontan, Centre Hospitalier Universitaire de Lille 59 037, Lille, France.
Journal of Affective Disorders (Impact Factor: 3.38). 08/2006; 93(1-3):169-76. DOI: 10.1016/j.jad.2006.03.009
Source: PubMed


Postnatal depression is a major public health problem. The aim of this study is to validate the use of the Edinburgh Postnatal Depression Scale (EPDS) in the early postpartum, and to identify the markers for risk of postnatal depression.
815 women filled out an EPDS and general information questionnaire between the third and the fifth day postpartum. The women with an EPDS score of >8 and a randomized control group from those with scores of <8 were contacted 8 weeks postpartum. 363 women therefore had a structured diagnostic interview by telephone at 8 weeks postpartum (MINI-DSM-IV), without knowledge of their EPDS scores, to screen for a major or minor depressive episode.
The sensitivity of EPDS was measured as 0.82 [0.78-0.86], with a positivity threshold of 9.5/30. For an estimated prevalence for all depressive episodes of 16.1%, the positive predictive value of EPDS was measured as 42.8% [39.1-46.5%]. Multivariate risk analysis using logistical regression identified the following as risk markers for postnatal depression: previous history of depression (postnatal or other), unemployment, premature delivery or stopping breast-feeding in the first month for non-medical reasons.
The use of EPDS between the third and fifth day postpartum is valid. An EPDS score of >10 should be completed by a clinical assessment and suitable management. The risk markers identified here are clinical indices that can be used for first-line early screening by non-psychiatric health workers.

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    • "The EPDS is a patient-rated depression screening tool widely validated in both pregnant and postpartum women that consists of 10 questions scored from 0 to 3 with a maximum score of 30. Scores ≥10 are consistent with clinical depression, and further evaluation is recommended (Evins et al. 2000; Jardri et al. 2006; Lee et al. 2001). The study population was derived from an urban, hospital-based clinic at the University of Pennsylvania in which the majority of patients are insured by Medicaid (95 %). "
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    ABSTRACT: In this study, we evaluated the association between prenatal depression symptoms adverse birth outcomes in African-American women. We conducted a retrospective cohort study of 261 pregnant African-American women who were screened with the Edinburgh Postnatal Depression Scale (EPDS) at their initial prenatal visit. Medical records were reviewed to assess pregnancy and neonatal outcomes, specifically preeclampsia, preterm birth, intrauterine growth retardation, and low birth weight. Using multivariable logistic regression models, an EPDS score ≥10 was associated with increased risk for preeclampsia, preterm birth, and low birth weight. An EPDS score ≥10 was associated with increased risk for intrauterine growth retardation, but after controlling for behavioral risk factors, this association was no longer significant. Patients who screen positive for depression symptoms during pregnancy are at increased risk for multiple adverse birth outcomes. In a positive, patient-rated depression screening at the initial obstetrics visit, depression is associated with increased risk for multiple adverse birth outcomes. Given the retrospective study design and small sample size, these findings should be confirmed in a prospective cohort study.
    Full-text · Article · Aug 2013 · Archives of Women s Mental Health
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    • "The current findings are in agreement with these observations. In contrast, significant positive association was observed between unemployment and postpartum depression in research conducted in France [44], Sweden [24], Turkey [45], Ireland [46], and the United Kingdom [22]. The significant positive association that we observed between employment and PPD was likely to be ascribed to job stress and its limitations for women in Iran. "
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    ABSTRACT: Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran. Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering. Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8% (95% CI: 27.7-41.7). A significant difference was observed among depression scores before and after delivery (P ≤ 0.001). Type of delivery (P = 0.044), low socioeconomic status (P = 0.011), and women having low educational level (P = 0.009) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95% CI: 1.22-2.28, P = 0.003). Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports.
    Full-text · Article · Jul 2013 · Depression research and treatment
    • "Prevalence rates for both major and minor depressive postpartum episode established by diagnostic interview were 16.1% in France (Jardri et al., 2006), 9.2% in Sweden (Andersson, Sundström-Poromaa, Wulff, Ǻström, & Bixo, 2006), and 10% in Norway (Berle, "
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    ABSTRACT: The aims of the study were (1) to establish prevalence of postpartum depression (PPD) in the community sample and to determine (2) the stability and (3) the longitudinal pattern of the elevated depression from pregnancy to postpartum. A sample of 272 women filled out the Edinburgh Postnatal Depression Scale (EPDS) on three occasions: in the third trimester of pregnancy at prenatal clinic, 2 days postpartum at the maternity ward, and 6 weeks postpartum by postal questionnaire. At 6 weeks postpartum the Structured Clinical Interview for DSM Disorders – Research version (SCID-I RV) was administered by telephone. According to the SCID, the prevalence of PPD in the community sample was 8.1%. The longitudinal pattern of depression from pregnancy to 6 weeks postpartum showed that the level of depression is moderately stable. However, the mean depression score decreased over time. The clinical implications of the findings are discussed.
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