A study recently published in the journal Pregnancy showed that psychological assessments before delivery, combined with measures of how well women are recovering after childbirth, could help identify those at higher risk of postpartum depression (PPD) earlier.
PPD is common, affecting about one in seven women within the first year after birth. While the study did not focus specifically on fetal and neonatal alloimmune thrombocytopeniaFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth. (FNAITFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth.), individuals affected by the condition are prone to psychological distress, putting them at an even greater risk of depression and anxiety after delivery.
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PPD can have devastating consequences, including disruptions in mother-baby bonding, negative effects on child development and increased risk of maternal death. Early detection and intervention is therefore necessary to prevent long-term damage.
For the study, researchers evaluated 603 women admitted for an intended vaginal delivery between June 2023 and October 2024. Before and after delivery, participants completed several validated assessments that measure different aspects of psychological health, including the Patient Health Questionnaire 4 (PHQ-4), Generalized Anxiety Disorder 7 (GAD-7), Pain Catastrophizing Scale (PCS-13) and Obstetric Quality of Recovery 10 (ObsQoR-10).
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At six weeks postpartum, they completed the Edinburgh Postnatal Depression Scale (EPDS), with an EPDS score of 13 or higher indicating elevated depressive symptoms. A total of 46 women, or 7.6% of the study group, met that threshold.
Researchers then developed models using 18 patient, obstetric and self-reported factors to determine whether women at risk of elevated depressive symptoms could be identified earlier. They found that a simplified prediction model using the GAD-7, ObsQoR-10 and length of hospital stay performed similarly to the more complicated model.
Using a risk threshold of greater than 15%, the researchers’ approach identified 16 of 36 women considered at high risk for elevated depressive symptoms on the day of hospital discharge. At one week postpartum, an additional 15 of 67 women were identified as high risk using the ObsQoR-10 and PHQ-4.
The findings suggest that screening for anxiety and depressive symptoms before delivery, alongside monitoring postpartum recovery, could give clinicians an earlier opportunity to identify women who may benefit from additional mental health support.
“Implementation into clinical practice of these findings could potentially lead to earlier PPD screening and treatment of this vulnerable population,” the researchers concluded.
