The utility of maternal depression screening in the third trimester.

Objective: The purpose of this study was to estimate the prevalence of maternal depressive risk in patients during the third trimester and to determine whether unique at-risk women are identified when the data are compared with postpartum screening.

Study Design: As part of a comprehensive program for universal perinatal depression screening and behavioral health referral of at-risk women, patients completed the Edinburgh Postnatal Depression Scale both during pregnancy (24-28 weeks of gestation) and again at 6 weeks after delivery. Based on Edinburgh Postnatal Depression Scale scores of > or =12, the prevalence of antepartum depressive risk and the rates of concordant/discordant risk status with the corresponding postpartum results were calculated. Discordant-risk cases were further analyzed to determine whether obstetric, psychosocial, or demographic variables were associated with changing risk status over time.

Results: We screened 1584 women in the third trimester and again after delivery: 7.7% and 6.8% of the women scored in the at-risk range in the antepartum and postpartum time frames, respectively; 88.9% of patients had the same risk status, and 11.1% were discordant before and after delivery. Statistically significant associations were found between premature birth, newborn infant admission to the intensive care nursery, and acquisition of postpartum depressive risk.

Conclusion: Screening for depression in the third trimester resulted in a comparable prevalence rate of depressive risk identification when compared with the postpartum time frame. Unique women were identified before and after delivery who may have been missed if screening had not been performed twice.