Screening for postpartum depression improves some maternal outcomes compared with no screening, but the overall improvement in long-term maternal and child outcomes is unclear, concludes a new research review from AHRQ’s Effective Health Care Program. The potential effectiveness of screening for postpartum depression appears to be related to the availability of systems to ensure adequate followup of women who screen positive.
The evidence reviewed for this report does little to resolve uncertainties from a 2005 AHRQ report on this subject. However, findings support the current U.S. Preventive Services Task Force recommendation of screening for depression in adults when adequate resources are available to ensure appropriate diagnostic and therapeutic services. Maternal postpartum depression has been associated with an increased risk of infant mortality, adverse effects on some measures of infant development, and increased health care resource use.
A history of mood disorder, poor relationship quality, and poor social support were all associated with a woman’s greater risk of postpartum depression. Much greater attention needs to be paid to an explicit definition of the goals of a postpartum depression screening strategy. The ideal characteristics of a screening test for postpartum depression, including sensitivity, specificity, timing, and frequency have not been defined. Because the balance of benefits and harms, at both the individual level and health system level, is highly dependent on these characteristics, broad consensus on these characteristics is needed.
These findings can be found in the research review, Efficacy and Safety of Screening for Postpartum Depression at http://go.usa.gov/TzAG.