Antepartum Services and Symptoms of Postpartum Depression in At-Risk Women

Ruyak, Sharon L.; Flores-Montoya, Angelina; Boursaw, Blake

doi:10.1016/j.jogn.2017.07.006

Cited by 8 publications

(13 citation statements)

References 31 publications

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“…The MBCT program was well attended (at least 5 out of 8 sessions) by a majority of the participants. Preliminary results suggest improvement in total EPDS score over time among those with symptoms of depression, as well as demonstrating that asymptomatic, but at risk, women did not have increasing EPDS scores as might be expected for 40% or more of women with the same risk factors for developing perinatal depression 15,18 However, as other observational studies have shown, EPDS scores may fall throughout pregnancy without intervention 17,19 . Randomized controlled trials have shown that MBCT interventions can be effective in reducing the incidence and recurrence of perinatal depression, as well as symptom severity among pregnant women, although modes of delivery and content of the intervention may affect impact 19 .…”

Section: Discussionmentioning

confidence: 96%

“…The perinatal depression risk checklist (Table 1), although not comprehensive, includes the strongest known predictors of perinatal depression, such as previous history of depression and recent significant life events. [14][15][16] These predictors have been used to reliably predict the occurrence of perinatal depression in population studies. 23,24 The checklist takes approximately 2 minutes or less to complete.…”

Section: Measures and Proceduresmentioning

confidence: 99%

“…15 Increasing numbers of stressful life events were also associated with postpartum depressive symptoms prevalence, up to 42% among those with 6 or more stressful life events. 15,16 Although screening by itself may help prevent perinatal depression, 17 a recent systematic review of interventions for pregnant women aimed at preventing perinatal depression concluded that counseling interventions can be more effective than usual care, without causing harm. 2 The evidence base for other interventions, including antidepressants, is insufficient to assess benefit or harm.…”

Section: Introductionmentioning

confidence: 98%

“…15 Preconception history of depression is an established risk factor for depression recurrence during pregnancy and postpartum, with an estimated 46% of such women in the United States reporting postpartum depressive symptoms. 15 Increasing numbers of stressful life events were also associated with postpartum depressive symptoms prevalence, up to 42% among those with 6 or more stressful life events. 15,16 Although screening by itself may help prevent perinatal depression, 17 a recent systematic review of interventions for pregnant women aimed at preventing perinatal depression concluded that counseling interventions can be more effective than usual care, without causing harm.…”

Section: Introductionmentioning

confidence: 99%

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A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study

Latendresse

Bailey

Iacob

et al. 2021

J Midwife Womens Health

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Introduction Perinatal depression occurs in 12% to 18% of childbearing women. Telehealth is a promising platform for delivering perinatal mental health care, particularly during a pandemic when in‐person services have been significantly curtailed. However, there is little research to document the feasibility of telehealth to address perinatal depression. This pilot study evaluated the feasibility and preliminary results of an 8‐week facilitated group videoconference intervention. Methods The study enrolled pregnant and postpartum women into an 8‐week group mindfulness‐based cognitive behavioral intervention, delivered via videoconference platform. Women receiving care at outpatient clinics who either screened positive for perinatal depression symptoms or had risk factors predictive of perinatal depression were invited to participate. Women attended weekly one‐hour group sessions using their own electronic device and completed the Edinburgh Postnatal Depression Scale (EPDS) at several time points. Session attendance and survey completion rates were evaluated. Results A total of 47 women enrolled (8 postpartum; 39 prenatal) into groups of 4 to 6. Twenty‐four (51.1%) women were currently experiencing mild to moderate perinatal depression symptoms (EPDS score of 10‐20), whereas 23 (48.9%) women had EPDS scores less than 10 but were at high risk for developing perinatal depression due to health history and significant life events. Seventy percent of women attended at least 5 of the 8 sessions. Trajectories of EPDS measures were promising (ie, downward among those with current perinatal depression symptoms and stable among those at high risk for developing perinatal depression). Discussion These observational results are promising, suggesting further study of effectiveness for women with symptoms of perinatal depression, as well as for women at high risk for developing perinatal depression. Randomized trials could evaluate the effectiveness of the intervention, compared with standard of care approaches. Telehealth interventions can be tailored to meet the needs of different communities, and increase access to care, regardless of where women live or inability to receive in‐person services.

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Section: Discussionmentioning

confidence: 96%

Section: Measures and Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study

Latendresse

Bailey

Iacob

et al. 2021

J Midwife Womens Health

View full text Add to dashboard Cite

show abstract

“…Risk factors that increase a woman’s susceptibility to behavioral health disorders in pregnancy include adverse childhood experiences (ACEs; Atzl et al., 2019 ), discrimination, economic adversity, disparate access to medical care, lack of social support, intimate partner violence (IPV), and substance use ( Latendresse et al., 2015 ; Mukherjee et al., 2017 ). Clustering of these factors is prevalent among disadvantaged women (those of racial minorities, those with low socioeconomic status, and teens), which further increases the likelihood of adverse health outcomes ( Latendresse et al., 2015 ; Ruyak et al., 2017 ). The COVID-19 pandemic has dramatically increased the risk of behavioral health disorders secondary to unprecedented worry surrounding infection, social isolation, and the unpredictable future.…”

Section: Introductionmentioning

confidence: 99%

Perinatal Behavioral Health, the COVID-19 Pandemic, and a Social Determinants of Health Framework

Ruyak¹,

Kivlighan²

2021

Journal of Obstetric, Gynecologic & Neonatal Nursing

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The United States has greater prevalence of mental illness and substance use disorders than other developed countries, and pregnant women are disproportionately affected. The current global COVID-19 pandemic, through the exacerbation of psychological distress, unevenly affects the vulnerable population of pregnant women. Social distancing measures and widespread closures of businesses secondary to COVID-19 are likely to continue for the foreseeable future and to further magnify psychosocial risk factors. We propose the use of a social determinants of health framework to integrate behavioral health considerations into prenatal care and to guide the implementation of universal and comprehensive psychosocial assessment in pregnancy. As the most numerous and well-trusted health care professionals, nurses are ideally positioned to influence program and policy decisions at the community and regional levels and to advocate for the full integration of psychosocial screening and behavioral health into prenatal and postpartum care as core components.

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Maternal Depression Scale: Do “Drop-In” Laborist Patients Have Increased Postpartum Screening Risks Compared to Patients with Adequate Prenatal Care?

Lua

Kelley

Jackson

2018

Matern Child Health J

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Objectives The Edinburgh Postnatal Depression Scale (EPDS) identifies women with depressive symptoms in pregnancy. Our primary objective was to determine the prevalence of EPDS screen-positive women delivering on our no prenatal care (laborist) service and to compare these patients to private patients delivering with prenatal care. Methods Retrospective cohort analysis of EPDS scores during January 1, 2015 to June 18, 2015 was conducted. Scores ≥ 10 were considered at-risk. Results were analyzed as an aggregate and then as no prenatal care versus prenatal care. Characteristics for patients with at-risk scores (EPDS ≥ 10) versus low-risk scores (EPDS < 10) were quantified. Results Analysis occurred on 970 women. EPDS ≥ 10 occurred in 12.4% (n = 120/970). Positive EPDS score was 21.1% without prenatal care versus 10.9% with adequate prenatal care (P = 0.003). Maternal demographics and delivery characteristics were clinically similar in patients with prenatal care compared to no prenatal care. Private insurance was more common in patients with prenatal care compared to no prenatal care (23.5 versus 8.1%, P = 0.0001). However, analysis of patients with EPDS > 10 showed non-significant distributions of ethnicity, private insurance, Medicaid, or no insurance compared to patients with EPDS < 10. Conclusion for Practice Patients without prenatal care who arrive solely for urgent "drop-in" delivery have a measurable increased risk factor for postpartum depressive symptoms. Ethnicity and payor status were related to adequacy of prenatal care but were not significant variables when analyzing patients with EPDS > 10. Laborist services providing care to "drop-in" patients should recognize this increased risk and develop policies for screening, referral and follow-up of at-risk patients.

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Antepartum Services and Symptoms of Postpartum Depression in At-Risk Women

Cited by 8 publications

References 31 publications

A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study

A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study

Perinatal Behavioral Health, the COVID-19 Pandemic, and a Social Determinants of Health Framework

Maternal Depression Scale: Do “Drop-In” Laborist Patients Have Increased Postpartum Screening Risks Compared to Patients with Adequate Prenatal Care?

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