IDentify, Educate and Alert (IDEA) trial: an intervention to reduce postnatal depression.
OBJECTIVE
To test the effectiveness of a prenatal intervention in reducing the incidence of postnatal depression.


METHODS
A randomized controlled trial.


METHODS
A large metropolitan obstetric hospital.


METHODS
Pregnant women with risk factors for postnatal depression.


METHODS
Women attending their first prenatal visit at the Royal Women's Hospital, Brisbane, were screened for risk factors for postnatal depression (IDentify). Positively screened women were randomly allocated to the intervention group or the control group. The intervention consisted of a booklet about postnatal depression, which included contact numbers; prenatal screening using the Edinburgh Postnatal Depression Scale; a discussion with the woman about her risk of developing postnatal depression (Educate); and a letter to the woman's referring general practitioner and local Child Health Nurse, alerting them of the woman's risk for postnatal depression (Alert).


METHODS
Edinburgh Postnatal Depression Scale Score > 12 at 16 weeks postpartum.


RESULTS
Of the 509 women who were sent a follow-up questionnaire, 371 (72.9%) responded. The proportion of women who reported an Edinburgh Postnatal Depression Scale score of >12 was 26%. There were no significant differences between intervention (46/192, 24%) and control groups (50/177, 28.2%) on this primary outcome measure (OR 0.80; 95% CI 0.50-1.28).


CONCLUSIONS
Over one-quarter of women with risk factors will develop postnatal depression. It is a treatable disorder but under-diagnosis is common. Efforts to reduce postnatal depression by implementing interventions in the prenatal period have been unsuccessful.
D000328:Adult; D019052:Depression, Postpartum / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012307:Risk Factors; D018401:Sample Size