The association between maternal depression and frequent non-routine visits to the infant's doctor--a cohort study.
BACKGROUND
Perinatal depression is common, but women typically do not seek help for it. We studied its association with frequent non-routine physician visits, which may be a form of help-seeking behaviour.


METHODS
A prospective cohort study of women in their 34th to 38th week of pregnancy at the outpatient obstetrics clinic at a Singapore tertiary hospital was done. Screening was done using the Edinburgh Postnatal Depression Scale and diagnosis of major or minor depressive disorder was made using the SCID-IV. At 6 to 12 months' post-partum, women were screened and interviewed again for depression and asked to report the frequencies with which they had brought their infants to the doctor on non-routine visits in the preceding 6 weeks. Four hundred and seventy-one of the 559 patients recruited before delivery were re-interviewed.


RESULTS
After adjusting for confounders, women who had brought their infants for three or more non-routine visits to the infant's doctor had a significantly higher prevalence of depression (32.6%) than those with fewer visits (13.6%) (OR 2.87, 95% CI 1.41 to 5.85, p=0.004). The relative risk reduction for women who did not bring their infants for frequent non-routine visits was 0.583 (95% CI 0.44 to 0.73, p=0.002). They were also more likely to have poorer perceived emotional support from their families.


CONCLUSIONS
These included use of self-reported doctor visits, and relatively high educational levels of the participants.


CONCLUSIONS
Doctors should have a high index of suspicion for enquiring about depression and emotional support in mothers who bring their infants for frequent non-routine visits.
Chee
Cornelia Y I
CY
Department of Psychological Medicine, National University Hospital, Lower Kent Ridge Road, Singapore 119074, Singapore. pcmcheec@nus.edu.sg
Chong
Yap-Seng
YS
Ng
T P
TP
Lee
Dominic T S
DT
Tan
L K
LK
Fones
Calvin S L
CS
D000328:Adult; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007224:Infant Care / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D010372:Pediatrics / Q000706:statistics & numerical data; D011247:Pregnancy; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data