Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia
Abstract Background and objectives The perinatal period presents a high-risk time for development of mood disorders. Australia-wide universal perinatal care, including depression screening, make this stage amenable to population-level preventative approaches. In a large cohort of women receiving pub...
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doaj-541e5be53c3240c7b63ed715f865c5c02020-11-25T03:58:27ZengBMCBMC Pregnancy and Childbirth1471-23932019-11-0119111410.1186/s12884-019-2565-3Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, AustraliaSarah Khanlari0John Eastwood1Bryanne Barnett2Sabrina Naz3Felix Akpojene Ogbo4Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health CentreDepartment of Community Paediatrics, Sydney Local Health District, Croydon Community Health CentreSydney Institute for Women Children and their Families, Sydney Local Health DistrictTranslational Health Research Institute, School of Medicine, Western Sydney UniversityTranslational Health Research Institute, School of Medicine, Western Sydney UniversityAbstract Background and objectives The perinatal period presents a high-risk time for development of mood disorders. Australia-wide universal perinatal care, including depression screening, make this stage amenable to population-level preventative approaches. In a large cohort of women receiving public perinatal care in Sydney, Australia, we examined: (1) the psychosocial and obstetric determinants of women who signal distress on EPDS screening (scoring 10–12) compared with women with probable depression (scoring 13 or more on EPDS screening); and (2) the predictive ability of identifying women experiencing distress during pregnancy in classifying women at higher risk of probable postnatal depression. Methods We analysed routinely collected perinatal data from all live-births within public health facilities from two health districts in Sydney, Australia (N = 53,032). Perinatal distress was measured using the EPDS (scores of 10–12) and probable perinatal depression was measured using the EPDS (scores of 13 or more). Logistic regression models that adjusted for confounding variables were used to investigate a range of psychosocial and obstetric determinants and perinatal distress and depression. Results Eight percent of this cohort experienced antenatal distress and about 5 % experienced postnatal distress. Approximately 6 % experienced probable antenatal depression and 3 % experienced probable postnatal depression. Being from a culturally and linguistically diverse background (AOR = 2.0, 95% CI 1.8–2.3, P < 0.001), a lack of partner support (AOR = 2.9, 95% CI 2.3–3.7) and a maternal history of childhood abuse (AOR = 1.9, 95% CI 1.6–2.3) were associated with antenatal distress. These associations were similar in women with probable antenatal depression. Women who scored 10 to12 on antenatal EPDS assessment had a 4.5 times higher odds (95% CI 3.4–5.9, P < 0.001) of experiencing probable postnatal depression compared with women scoring 9 or less. Conclusion Antenatal distress is more common than antenatal depressive symptoms and postnatal distress or depression. Antenatal maternal distress was associated with probable postnatal depression. Scale properties of the EPDS allows risk-stratification of women in the antenatal period, and earlier intervention with preventively focused programs. Prevention of postnatal depression could address a growing burden of illness and long-term complications for mothers and their infants.http://link.springer.com/article/10.1186/s12884-019-2565-3PerinatalPregnancyDistressDepressionEPDSScreening |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sarah Khanlari John Eastwood Bryanne Barnett Sabrina Naz Felix Akpojene Ogbo |
spellingShingle |
Sarah Khanlari John Eastwood Bryanne Barnett Sabrina Naz Felix Akpojene Ogbo Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia BMC Pregnancy and Childbirth Perinatal Pregnancy Distress Depression EPDS Screening |
author_facet |
Sarah Khanlari John Eastwood Bryanne Barnett Sabrina Naz Felix Akpojene Ogbo |
author_sort |
Sarah Khanlari |
title |
Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia |
title_short |
Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia |
title_full |
Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia |
title_fullStr |
Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia |
title_full_unstemmed |
Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia |
title_sort |
psychosocial and obstetric determinants of women signalling distress during edinburgh postnatal depression scale (epds) screening in sydney, australia |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2019-11-01 |
description |
Abstract Background and objectives The perinatal period presents a high-risk time for development of mood disorders. Australia-wide universal perinatal care, including depression screening, make this stage amenable to population-level preventative approaches. In a large cohort of women receiving public perinatal care in Sydney, Australia, we examined: (1) the psychosocial and obstetric determinants of women who signal distress on EPDS screening (scoring 10–12) compared with women with probable depression (scoring 13 or more on EPDS screening); and (2) the predictive ability of identifying women experiencing distress during pregnancy in classifying women at higher risk of probable postnatal depression. Methods We analysed routinely collected perinatal data from all live-births within public health facilities from two health districts in Sydney, Australia (N = 53,032). Perinatal distress was measured using the EPDS (scores of 10–12) and probable perinatal depression was measured using the EPDS (scores of 13 or more). Logistic regression models that adjusted for confounding variables were used to investigate a range of psychosocial and obstetric determinants and perinatal distress and depression. Results Eight percent of this cohort experienced antenatal distress and about 5 % experienced postnatal distress. Approximately 6 % experienced probable antenatal depression and 3 % experienced probable postnatal depression. Being from a culturally and linguistically diverse background (AOR = 2.0, 95% CI 1.8–2.3, P < 0.001), a lack of partner support (AOR = 2.9, 95% CI 2.3–3.7) and a maternal history of childhood abuse (AOR = 1.9, 95% CI 1.6–2.3) were associated with antenatal distress. These associations were similar in women with probable antenatal depression. Women who scored 10 to12 on antenatal EPDS assessment had a 4.5 times higher odds (95% CI 3.4–5.9, P < 0.001) of experiencing probable postnatal depression compared with women scoring 9 or less. Conclusion Antenatal distress is more common than antenatal depressive symptoms and postnatal distress or depression. Antenatal maternal distress was associated with probable postnatal depression. Scale properties of the EPDS allows risk-stratification of women in the antenatal period, and earlier intervention with preventively focused programs. Prevention of postnatal depression could address a growing burden of illness and long-term complications for mothers and their infants. |
topic |
Perinatal Pregnancy Distress Depression EPDS Screening |
url |
http://link.springer.com/article/10.1186/s12884-019-2565-3 |
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