Postpartum Depression in the NICU

Blucker, Ryan T.; Gillaspy, J. Arthur; Jackson, Dennis L.; Hetherington, Carla; Kyler, Kathy; Cherry, Amy; McCaffree, Mary Anne; Gillaspy, Stephen R.

doi:10.1097/anc.0000000000000135

Cited by 9 publications

(12 citation statements)

References 29 publications

(24 reference statements)

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“…The PDSS 31 is a 35-item self-report Likert scale used to assess symptoms of PPD. The PDSS is one of the most widely used screeners of PPD 10 , 31 and has established validity and good internal consistency, 0.83–0.94. 31 The PDSS was chosen for this study over other commonly used PPD screening tools such as the Edinburgh Postnatal Depression Scale (EPDS), specifically due to items with a focus on motherhood.…”

Section: Methodsmentioning

confidence: 99%

“… 11 McCabe et al 33 found the psychometric properties of the PDSS scores to be well supported with excellent estimates of internal consistency of total PDSS scores and adequate-to-good for subscale scores, with a NICU population. Additionally, Blucker et al 10 found preliminary validation of a 15-item variation of the PDSS within the NICU setting. Total PDSS score was used in the analyses to assess maternal report of PPD symptoms.…”

Section: Methodsmentioning

confidence: 99%

“… 20 There is a great need for PPD screening in the NICU and this has been consistently supported in the literature. 7 , 10 , 23 However, many institutions and providers decide against implementation or try and struggle, due to many barriers encountered.…”

Section: Limitationsmentioning

confidence: 99%

“…The stressors experienced by mothers of infants in the NICU vary from those of term infants and occur at higher rates. 9 , 10 For example, parents of NICU infants often experience high stress, feelings of helplessness, and uncertainty about how to interact with their neonate during the NICU stay. 11 – 14 Additional risk factors for PPD specific within the NICU population have been suggested to include perception of the infant’s illness severity, poor coping skills, increased parenting stress, and length of stay in the NICU.…”

Section: Introductionmentioning

confidence: 99%

“… 4 The implementation of screeners in general as well as in the NICU has been consistently supported by proven interventions. 10 …”

Section: Introductionmentioning

confidence: 99%

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Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

Cherry¹,

Blucker²,

Thornberry³

et al. 2016

JMDH

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ObjectiveThe aims of this project were to describe the development of a postpartum depression screening program for mothers of infants in the Neonatal Intensive Care Unit and assess the implementation of the screening program.MethodsScreening began at 14 days postpartum and was implemented as part of routine medical care. A nurse coordinator facilitated communication with mothers for increasing screen completion, review of critical self-harm items, and making mental health referrals. During the 18-month study period, 385 out of 793 eligible mothers completed the screen.ResultsApproximately 36% of mothers had a positive screen that resulted in a mental health referral and an additional 30% of mothers had screening results indicating significant symptoms.ConclusionSeveral barriers were identified, leading to adjustments in the screening process, and ultimately recommendations for future screening programs and research. Development of a postpartum depression screening process in the Neonatal Intensive Care Unit involves support, training, implementation, and coordination from administrators, medical staff, new mothers, and mental health specialists. Several predictable challenges to program development require ongoing assessment and response to these challenges.RelevanceThis study highlights the expanding role of the psychologist and behavioral health providers in health care to intervene as early as possible in the life of a child and family with medical complications through multidisciplinary program development and implementation, as well as key considerations for institutions initiating such a program.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 4 The implementation of screeners in general as well as in the NICU has been consistently supported by proven interventions. 10 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

Cherry¹,

Blucker²,

Thornberry³

et al. 2016

JMDH

Self Cite

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Assessment of Patient-Reported Outcome Measures for Maternal Postpartum Depression Using the Consensus-Based Standards for the Selection of Health Measurement Instruments Guideline

et al. 2022

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IMPORTANCE Maternal depression is frequently reported in the postpartum period, with an estimated prevalence of approximately 15% during the first postpartum year. Despite the high prevalence of postpartum depression, there is no consensus regarding which patient-reported outcome measure (PROM) should be used to screen for this complex, multidimensional construct. OBJECTIVETo evaluate psychometric measurement properties of existing PROMs of maternal postpartum depression using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline and identify the best available patient-reported screening measure. EVIDENCE REVIEW This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. PubMed, CINAHL, Embase, and Web of Science were searched on July 1, 2019, for validated PROMs of postpartum depression, and an additional search including a hand search of references from eligible studies was conducted in June 2021. Included studies evaluated 1 or more psychometric measurement properties of the identified PROMs. A risk-of-bias assessment was performed to evaluate methods of each included study. Psychometric measurement properties of each PROM were rated according to COSMIN criteria. A modified Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the level of evidence supporting each rating, and a recommendation class (A, recommended for use; B, further research required; or C, not recommended) was given based on the overall quality of each included PROM. FINDINGS Among 10 264 postpartum recovery studies, 27 PROMs were identified. Ten PROMs (37.0%) met the inclusion criteria and were used in 43 studies (0.4%) involving 22 095 postpartum women. At least 1 psychometric measurement property was assessed for each of the 10 validated PROMs identified. Content validity was sufficient in all PROMs. The Edinburgh Postnatal Depression Scale (EPDS) demonstrated adequate content validity and a moderate level of evidence for sufficient internal consistency (with sufficient structural validity), resulting in a recommendation of class A. The other 9 PROMs evaluated received a recommendation of class B. CONCLUSIONS AND RELEVANCEThe findings of this systematic review suggest that the EPDS is the best available patient-reported screening measure of maternal postpartum depression. Future studies should focus on evaluating the cross-cultural validity, reliability, and measurement error of the EPDS to improve understanding of its psychometric properties and utility.

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Psychometric properties of the postpartum depression screening scale beyond the postpartum period

Vogeli

Hooker

Everhart

et al. 2018

Research in Nursing & Health

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Accurate postpartum depression screening measures are needed to identify mothers with depressive symptoms both in the postpartum period and beyond. Because it had not been tested beyond the immediate postpartum period, the reliability and validity of the Postpartum Depression Screening Scale (PDSS) and its sensitivity, specificity, and predictive value for diagnoses of major depressive disorder (MDD) were assessed in a diverse community sample of 238 mothers of 4- to 15-month-old infants. Mothers (N = 238; M age = 30.2, SD = 5.3) attended a lab session and completed the PDSS, the Beck Depression Inventory-II (BDI-II), and a structured clinical interview (SCID) to diagnose MDD. The reliability, validity, specificity, sensitivity, and predictive value of the PDSS to identify maternal depression were assessed. Confirmatory factor analysis supported the construct validity of five but not seven content subscales. The PDSS total and subscale scores demonstrated acceptable to high reliability (α = 0.68-0.95). Discriminant function analysis showed the scale correctly provided diagnostic classification at a rate higher than chance alone. Sensitivity and specificity for major depressive disorder (MDD) diagnosis were good and comparable to those of the BDI-II. Even in mothers who were somewhat more diverse and had older infants than those in the original normative study, the PDSS appears to be a psychometrically sound screener for identifying depressed mothers in the 15 months after childbirth.

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Postpartum Depression in the NICU

Cited by 9 publications

References 29 publications

Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

Assessment of Patient-Reported Outcome Measures for Maternal Postpartum Depression Using the Consensus-Based Standards for the Selection of Health Measurement Instruments Guideline

Psychometric properties of the postpartum depression screening scale beyond the postpartum period

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