The importance of assessing risk for depression in pregnant and postnatal mothers
Depression during pregnancy and in the first year after giving birth affects up to 15 per cent of women, with three per cent experiencing moderate to severe depression and suicide identified as one of the leading causes of indirect maternal mortality.
Routine assessment in pregnant and postnatal mothers can help reduce negative outcomes for mothers, infants and families and impact positively on the mental health of the next generation, an editorial in the Medical Journal of Australia says.
Mental health risk assessment plus depression screening using the Edinburgh Postnatal Depression Scale (EPDS) has been increasingly used in many parts of Australia over the last few years, and is now recommended in the 2011 National beyondblue Perinatal Depression Clinical Practice Guidelines.
Its clinical effectiveness has yet to be tested, Prof Marie-Paule Austin of St John of God Health Care and the University of New South Wales and co-authors wrote.
A recent randomised controlled trial of early postnatal screening using the EPDS, including supportive counselling where indicated, showed improved maternal mental health outcomes six months after birth for women receiving the intervention compared with those receiving usual care.
“In a meta-analysis of screening interventions for general depression, screening was found to be beneficial as long as it was integrated with clear pathways to care,” Prof Austin said.
There is now a need to know if combining assessment and pathways to care also is effective for pregnant women and women in the first year after birth.
“In addition, an evaluation of the impact of the National Perinatal Depression Initiative on mental health outcomes for mothers is critical if we are to optimise the quality and uptake of services for this vulnerable, yet highly accessible, population.”
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACT: Prof Marie-Paule Austin 0401 039 913
Ms Veronika Ilnycky 0400 260 160
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St John of God Health Care