Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice

Abstract

Perinatal depression is the most common obstetric complication in the United States, with prevalence rates of 15% to 20% among new mothers. Untreated, it can adversly affect the well-being of children and families throught increasing the risk for costly complications during birth and lead to deterioration of core supports, including partner relationships and social networks. Perinatal depression contributes to long-lasting, and even permanent, consequences for the physical and mental health of parents and children, including poor family functioning, increased risk of child abuse and neglect, delayed infant development, perinatal obstetric complications, challenges with breastfeeding, and costly increases in health care use. Perinatal depression can interfere with early parent-infant interaction and attachment, leading to potentially long-term disturbances in the child's physical, emotional, cognitive, and social development. Fortunately, perinatal depression is identifiable and treatable. The US Preventive Services Task Force, Centers for Medicare and Medicaid Services, and many professional organizations recommend routine universal screening for perinatal depression in women to facilitate early evidence-based treatment and referrals, if necessary. Despite significant gains in screening rates from 2004 to 2013, a minority of pediatricians routinely screen for postpartum depression, and many mothers are still not identified or treated. Pediatric primary care clinicians, with a core mission of promoting child and family health, are in an ideal position to implement routine postpartum depression screens at several well-child visits throughout infancy and to provide mental health support through referrals and/or the interdisciplinary services of a pediatric patient-centered medical home model.

Proof-of-Concept Support for the Development and Implementation of a Digital Assessment for Perinatal Mental Health: Mixed Methods Study

“…The vast majority of women and one-third of partners expressed having experienced poor mental health during the perinatal period, with the most typical conditions encountered by midwives throughout their careers being depression, anxiety, and PTSD. Critically, and in line with previous findings, rates of diagnoses were low relative to the number of individuals reporting concerns (eg, [29][30][31]). Perhaps more alarmingly, however, was the fact that the majority of respondents had referred themselves to an HCP, rather than being identified by a midwife as requiring further evaluation.…”

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

“…This finding is consistent with the more general finding that racial and ethnic minorities are less likely to receive mental health services when compared to non-Latinx White persons after controlling for multiple demographic characteristics and disorder severity [12]. The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) [13] have called for women to receive depression screening and referral to intervention during the first year postpartum [14]. Evidence suggests, however, that the majority of women with depressive symptoms do not receive screening and appropriate treatment [15], even within systems reportedly conducting universal screening [16].…”

Perinatal Depression of Exposed Maternal Women in the COVID-19 Pandemic in Wuhan, China

“…Therefore, perinatal mothers deserve priority in psychological health guarantees (12). Maternal depression is one of the most common complications among perinatal women, which may result in devastating life events to mothers, infants, and families (13). Perinatal depression may have negative effects on offspring well-being throughout their whole life (14)(15)(16).…”