Depression Screening in Antepartum Females
Michelle Burk, MSN, APRN, WHNP-BC
- Sigma Affiliation
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Problem Statement: Perinatal mood disorders, including depression, affects one in five pregnant or postpartum females. The American College of Obstetricians and Gynecologists (ACOG) and the US Preventative Task Force (USPTF) recommended screening for depression at least once during the antepartum and postpartum periods. The purpose of this quality improvement initiative was to introduce depression screening using the patient health questionnaire (PHQ) in antepartum women in a Midwestern private OB-GYN practice.
Methods: An observational, descriptive, cohort design utilizing a retrospective record review was used to evaluate for PHQ depression screening. A convenience sample of antepartum patients at/or around 36-weeks gestation was studied. A Plan-do-study-act (PDSA) cycle was utilized.
Results: There were 66 prenatal visits from January 2nd through March 20th, 2019. Of those, 54 patients (N=54) were screened with the PHQ-2 and four were screened further with the PHQ-9 (n=4). Most women screened negative for antepartum depression at 36-weeks gestation (n=50), but the PHQ-2 identified four at risk and in need of further evaluation with the PHQ-9 (χ2=39.19, df = 1, p<0.001); hence, approximately one in twenty patients screened positive for depression at/or around 36-weeks gestation. All patients who screened positive on the PHQ-9 were treated with medication and referred for counseling services.
Implications for Practice: Early identification of depression in pregnant females allowed for early medication management and counseling services. Further study is needed to determine if depression treatment during the antepartum period impacts the postpartum period.
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