Risk factors for positive postpartum depression screen in women with private health insurance and access to care

Marti D. Soffer, Zoe M. Adams, Yiting S. Chen, Nathan S. Fox

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective: To determine risk factors for a positive postpartum depression screen among women with private health insurance and 24/7 access to care. Study design: Retrospective cohort study of all patients delivered by a single MFM practice from April 2015 to September 2016. All patients had private health insurance and 24/7 access to care. All patients were scheduled to undergo the Edinburgh Postnatal Depression Scale (EPDS) at their 6-week postpartum visit and a positive screen was defined as a score of 10 or higher, or a score greater than zero on question 10 (thoughts of selfharm). Using logistic regression, risk factors for postpartum depression were compared between women with and without a positive screen. Results: Of the 1237 patients delivered, 1113 (90%) were screened with the EPDS. 81 patients (7.3, 95%CI 5.9–9.0%) of those tested had a positive screen. On regression analysis, risk factors associated with a positive screen were nulliparity (aOR 1.8, 95%CI 1.1, 2.9), cesarean delivery (aOR 1.7, 95%CI 1.1, 2.8), non-White race (aOR 2.0, 95%CI 1.1, 3.5), and a history of depression or anxiety (aOR 4.6, 95%CI 2.6, 8.1). Among the 100 women with a history of depression or anxiety, selective serotonin reuptake inhibitor (SSRI) use in the postpartum period was not associated with a reduced risk of a positive screen (25.5% in those taking an SSRI versus 18.4% of those not taking an SSRI, p =.39). Conclusions: Among women with private health insurance and access to care, the incidence of a positive screen for postpartum depression is approximately 7%. The use of an SSRI did not eliminate this risk. All women should be screened for postpartum depression.

Original languageEnglish
Pages (from-to)4154-4158
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume32
Issue number24
DOIs
StatePublished - 17 Dec 2019

Keywords

  • Access to care
  • Edinburgh
  • health insurance
  • postpartum depression

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