Depression screening advised during and after pregnancy

A new Committee Opinion issued by the American College of Obstetricians and Gynecologists advises clinicians to screen their patients for depression during their pregnancy and postpartum.

According to ACOG, 14% to 23% of pregnant women experience symptoms of depression during their pregnancy and 5% to 25% will experience postpartum depression. During pregnancy, maternal depression can lead to preeclampsia, preterm delivery, and low birth weight. Left untreated, maternal depression can negatively affect cognitive, neurologic, and motor skill development in the infant and the behavior and mental health of older children.

“With over 4 million births in the US every year, we’re talking about huge number of women with postpartum depression: between 200,000 to more than 1 million each year,” Gerald F. Joseph, MD, president of ACOG, said. “Unfortunately, we don’t have the data at this time to support a firm recommendation for universal antepartum and postpartum depression screening.

Noting that the perinatal period may be an appropriate time to screen because the mother is already seeing healthcare providers regularly, the Committee Opinion identifies a number of screening tools that take less than 10 minutes’ time and have specificity of 77% to 100%. The physician should decide which screening tools to incorporate, who should conduct the screening, and the frequency of screenings. Screenings are advised at least once during pregnancy and once postpartum. After physicians have screened patients, at-risk patients should be referred to an appropriate professional.

The committee opinion also recommended that medical practices consult payers before billing for depression screening.

Pinette MG, Wax JR. Obstet Gynecol. 2010; 115(1): 188-189.