title: Universal versus risk factor-targeted early inpatient postpartum depression screening.
abstract: OBJECTIVE
  To assess differences in two different approaches to early inpatient Edinburgh Postnatal Depression Scale (EPDS) screening (targeted risk factor screening versus universal screening).
  
  
  METHODS
  Retrospective study of two cohorts delivering from January 2010 to June 2010. Cohort 1 included 5-weeks of consecutive deliveries. Risk factors for a positive EPDS screen were determined by multivariable logistic regression. Cohort 2 included all delivering women in the subsequent 5 months who had the most common risk factor (history of mental illness) for postpartum depression identified from Cohort 1.
  
  
  RESULTS
  For Cohort 1 of universal screening (N = 322), 11 (3.4%) had positive screens with seven (63.6%) having a history of any mental illness yielding the number needed to screen to identify one EPDS positive mother of 29. For Cohort 2 (N = 215), there were 33 (15.3%) positive screens and the number needed to have a positive screen was 6. Without a history of mental illness, predictive models for a positive screen were poor with the number needed to screen of 80.
  
  
  CONCLUSIONS
  Early EPDS screening targeted for those with a history of mental illness is an efficient way to identify postpartum women with active mental health problems, but may miss up to 36.4% of potential screen positive women.
authors.affiliation: Department of Obstetrics and Gynecology, Lehigh Valley Health Network , Allentown, PA , USA .
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Berger
authors.forename: Amy
authors.initials: A
authors.lastname: Wu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Smulian
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Quiñones
authors.forename: Sandra
authors.initials: S
authors.lastname: Curet
authors.forename: Rory L
authors.initials: RL
authors.lastname: Marraccini
authors.forename: John C
authors.initials: JC
authors.lastname: Smulian
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008403:Mass Screening; D008487:Medical History Taking; D015999:Multivariate Analysis; D049590:Postpartum Period; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: Edinburgh Postpartum Depression Scale; mental health; pregnancy