title: A prospective study of postpartum depression in 17 648 parturients.
abstract: OBJECTIVE
  To assess perinatal antecedents to postpartum depression (PPD).
  
  
  METHODS
  This was a prospective population-based, observational study of women screened for symptoms of depression using the Edinburgh Postnatal Depression Scale (EPDS) with scores ≥13 referred for psychiatric evaluation. Obstetric and neonatal outcomes were analyzed using univariable and multivariable analysis for associations with postpartum depressive symptoms.
  
  
  RESULTS
  Of 25 050 women delivered, 17 648 (71%) completed EPDS questionnaires with 1106 (6.3%) scoring ≥13. Perinatal complications most associated with EPDS scores ≥13 included major malformation (adjusted OR 1.5; 95% CI, 1.1-2.3), neonatal death (adjusted OR 5.8; 95% CI, 2.9-11.4), stillbirth (adjusted OR 9.4; 95% CI, 6.0-14.8), and necrotizing enterocolitis (adjusted OR 21.7; 95% CI, 1.9-244.3). A total of 238 (22%) women kept their psychiatric referral appointment, and 111 (47%) were diagnosed with PPD. Perinatal factors were also found to be significantly associated with PPD.
  
  
  CONCLUSIONS
  PPD is significantly increased in women with adverse pregnancy outcomes, especially involving the infant.
authors: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA. davidb.nelson@utsouthwestern.edu
authors: David B
authors: DB
authors: Nelson
authors: Marlene P
authors: MP
authors: Freeman
authors: Neysa L
authors: NL
authors: Johnson
authors: Donald D
authors: DD
authors: McIntire
authors: Kenneth J
authors: KJ
authors: Leveno
mesh_terms: D000293:Adolescent; D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000523:psychology; D010349:Patient Compliance / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D012017:Referral and Consultation; D013781:Texas / Q000453:epidemiology; D055815:Young Adult