Predictive validation study of the Edinburgh Postnatal Depression Scale in the first week after delivery and risk analysis for postnatal depression.
BACKGROUND
Postnatal depression is a major public health problem. The aim of this study is to validate the use of the Edinburgh Postnatal Depression Scale (EPDS) in the early postpartum, and to identify the markers for risk of postnatal depression.


METHODS
815 women filled out an EPDS and general information questionnaire between the third and the fifth day postpartum. The women with an EPDS score of >8 and a randomized control group from those with scores of <8 were contacted 8 weeks postpartum. 363 women therefore had a structured diagnostic interview by telephone at 8 weeks postpartum (MINI-DSM-IV), without knowledge of their EPDS scores, to screen for a major or minor depressive episode.


RESULTS
The sensitivity of EPDS was measured as 0.82 [0.78-0.86], with a positivity threshold of 9.5/30. For an estimated prevalence for all depressive episodes of 16.1%, the positive predictive value of EPDS was measured as 42.8% [39.1-46.5%]. Multivariate risk analysis using logistical regression identified the following as risk markers for postnatal depression: previous history of depression (postnatal or other), unemployment, premature delivery or stopping breast-feeding in the first month for non-medical reasons.


CONCLUSIONS
The use of EPDS between the third and fifth day postpartum is valid. An EPDS score of >10 should be completed by a clinical assessment and suitable management. The risk markers identified here are clinical indices that can be used for first-line early screening by non-psychiatric health workers.
Jardri
Renaud
R
Hôpital Michel Fontan, Centre Hospitalier Universitaire de Lille 59 037, Lille, France. r.jardri@free.fr
Pelta
Jerome
J
Maron
Michel
M
Thomas
Pierre
P
Delion
Pierre
P
Codaccioni
Xavier
X
Goudemand
Michel
M
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011247:Pregnancy; D011594:Psychometrics / Q000706:statistics & numerical data; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D014478:Unemployment