The Utility of Screening for Perinatal Depression in the Second Trimester

Tuesday, July 12, 2011: 9:10 AM

Ying Lau, PhD
School of Health Sciences, Macao Polytechnic Institute, Macao, Macau

Learning Objective 1: To study the pattern of perinatal depressive symptomatology among Chinese pregnant women.

Learning Objective 2: To determine the sensitivity, specificity, and predictive validity of second trimester perinatal depressive symptoms for future perinatal periods.

Purpose:

To study the pattern of perinatal depressive symptomatology and determine the sensitivity, specificity, and predictive validity of second trimester perinatal depressive symptoms for future perinatal periods.

Methods:  

A population-based sample of 2,178 women completed the Edinburgh Postnatal Depression Scale (EDPS) in the second and third trimesters and at 6 weeks postpartum. The sensitivity, specificity, and predictive power of the second trimester EPDS score in identifying women with an elevated EPDS score in the third trimester and at 6 weeks postpartum were determined. The predictive power of the second trimester EPDS score was further assessed using stepwise logistic regression and receiver operator characteristic (ROC) curves.

Results:

The rates were 9.9%, 7.8%, and 8.7% for an EPDS score of > 14 in the second and third trimesters and at 6 weeks postpartum, respectively. Using a cut-off of 14/15, the second trimester EPDS score accurately classified 89.6% of women in the third trimester and 87.2% of those at 6 weeks postpartum with or without perinatal depressive symptomatology. Women with a second trimester EPDS score > 14 were 11.78 times more likely in the third trimester and 7.15 times more likely at 6 weeks postpartum to exhibit perinatal depressive symptomatology after adjustment. The area under the curve (AUC) for perinatal depressive symptomatology was 0.85 in the third trimester and 0.77 at 6 weeks postpartum. 

Conclusion:

To identify women at high risk for postpartum depression, healthcare professionals could consider screening all pregnant women in the second trimester so that secondary preventive intervention may be implemented.