title: Identification of antenatal depression in obstetric care.
abstract: OBJECTIVE
  Detection rates of depression in obstetric care are generally low, and many women remain undiagnosed and do not receive adequate support. In many obstetric settings, screening tools for depression are not applied routinely and there is a great need to sensitize health care professionals for the patient at risk for enhanced levels of depression. The present study aimed at identifying commonly assessed patient characteristics that are associated with antenatal depression.
  
  
  METHODS
  One hundred and thirty seven women were screened using the Edinburgh Postnatal Depression Scale (EPDS) at the beginning of the second trimester at the outpatient department of a Tertiary University Hospital. Women were identified as at high risk for depression if scores were above a cut-off score of twelve. Obstetric history and outcome were extracted from patient files after delivery.
  
  
  RESULTS
  Twenty one percent of the sample screened as depression positive. Logistic regression with backwards elimination showed that the triad of nausea during pregnancy, reports of (premature) contractions and consumption of analgesics during pregnancy significantly predicted high depression scores with a positive predictive value of 84.3%. The relative risk for a depressed pregnant woman to regularly take analgesics during pregnancy was fourfold higher than for non-depressed women.
  
  
  CONCLUSIONS
  If depression screening is not part of routine prenatal care, systematic assessment of depression should be targeted for patients presenting with the markers identified in this study.
authors.affiliation: University Women's Hospital, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland. jalder@uhbs.ch
authors.forename: Judith
authors.initials: J
authors.lastname: Alder
authors.forename: Nadine
authors.initials: N
authors.lastname: Fink
authors.forename: Corinne
authors.initials: C
authors.lastname: Urech
authors.forename: Irene
authors.initials: I
authors.lastname: Hösli
authors.forename: Johannes
authors.initials: J
authors.lastname: Bitzer
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D009325:Nausea / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014590:Uterine Contraction / Q000502:physiology; D055815:Young Adult
chemical_list: D000700:Analgesics