PMID- 37020205
OWN - NLM
STAT- MEDLINE
DCOM- 20230430
LR  - 20230430
IS  - 1471-2393 (Electronic)
IS  - 1471-2393 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Apr 5
TI  - Co-occurrence of depression, anxiety, and perinatal posttraumatic stress in 
      postpartum persons.
PG  - 232
LID - 10.1186/s12884-023-05555-z [doi]
LID - 232
AB  - BACKGROUND: The study aim was to describe the incidence of depression, anxiety, 
      perinatal-post-traumatic stress disorder (PTSD), and their co-occurrences in the 
      early postpartum period in a low-resource OB/GYN clinic serving majority 
      Medicaid-eligible persons. We hypothesized that postpartum persons screening 
      positive for depression will have an increased risk of a positive screen for 
      anxiety and perinatal PTSD. METHODS: A retrospective study of postpartum persons 
      receiving care in Baton Rouge, Louisiana was conducted using responses abstracted 
      from the electronic medical record (EMR) of the Patient Health Questionnaire-9 
      (PHQ9), Generalized Anxiety Disorder-7 (GAD7), and Perinatal Post Traumatic 
      Stress Disorder Questionnaire-II (PPQII). Categorical distributions were compared 
      using Fisher exact tests, while t-tests were used to compare continuous 
      covariates. Multivariable logistic regression was used to predict anxiety (GAD7) 
      and perinatal PTSD (PPQII) scores while adjusting for potential confounders, as 
      well as to predict continuous PPQII and GAD7 based on continuous PHQ9 scores. 
      RESULTS: There were 613 birthing persons 4-12 weeks postpartum that completed 
      mental health screening (PHQ9, GAD7, and PPQII) between November 2020 and June 
      2022 as part of routine postpartum care in the clinic. The incidence of screening 
      positive for symptoms of depression (PHQ9 > 4) was 25.4% (n = 156), while the 
      incidence of positive screening for symptoms of anxiety (GAD7 > 4) and perinatal 
      PTSD (PPQII [Formula: see text] 19) were 23.0% (n = 141) and 5.1% (n = 31) 
      respectively. Postpartum patients with mild anxiety or more (i.e. GAD7 > 4) had 
      26 times higher odds of screening positive for symptoms of depression (PHQ9 > 4) 
      (adjusted odds ratio [aOR] 26.3; 95% confidence interval [CI] 15.29-46.92; 
      p < 0.001). Postpartum persons with a PPQII score indicating symptoms of 
      perinatal PTSD (PPQII [Formula: see text] 19) had 44 times higher odds of 
      screening positive for symptoms of depression (PHQ > 4) (aOR 44.14; 95%CI 
      5.07-5856.17; p < 0.001). CONCLUSIONS: Depression, anxiety, and perinatal PTSD 
      are each independent risk factors for each other. To comply with the American 
      College of Obstetricians and Gynecologists (ACOG) recommendations, providers 
      should universally screen postpartum persons with validated screening tools for 
      mood disturbances. However, if a complete full mood assessment is not feasible, 
      this study provides evidence to support screening patients for depression, and if 
      the patient screens positive, prompt additional screening for anxiety and 
      perinatal PTSD.
CI  - (c) 2023. The Author(s).
FAU - Howard, Shelby
AU  - Howard S
AD  - Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
FAU - Witt, Caitlin
AU  - Witt C
AD  - Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
FAU - Martin, Karla
AU  - Martin K
AD  - Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
FAU - Bhatt, Ateshi
AU  - Bhatt A
AD  - Woman's Hospital, 100 Woman's Way, Baton Rouge, LA, 70817, USA.
FAU - Venable, Emily
AU  - Venable E
AD  - Woman's Hospital, 100 Woman's Way, Baton Rouge, LA, 70817, USA.
FAU - Buzhardt, Sarah
AU  - Buzhardt S
AD  - Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
FAU - Chapple, Andrew G
AU  - Chapple AG
AD  - Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
FAU - Sutton, Elizabeth F
AU  - Sutton EF
AD  - Woman's Hospital, 100 Woman's Way, Baton Rouge, LA, 70817, USA. 
      Elizabeth.Sutton@womans.org.
LA  - eng
PT  - Journal Article
DEP - 20230405
PL  - England
TA  - BMC Pregnancy Childbirth
JT  - BMC pregnancy and childbirth
JID - 100967799
SB  - IM
MH  - Female
MH  - Humans
MH  - Pregnancy
MH  - *Anxiety/epidemiology/psychology
MH  - Anxiety Disorders
MH  - Depression/epidemiology
MH  - *Depression, Postpartum/diagnosis
MH  - Postpartum Period/psychology
MH  - Retrospective Studies
MH  - *Stress Disorders, Post-Traumatic/epidemiology
MH  - Surveys and Questionnaires
MH  - Comorbidity
PMC - PMC10074651
OTO - NOTNLM
OT  - Anxiety
OT  - Depression
OT  - Perinatal mental health
OT  - Perinatal posttraumatic stress
OT  - Pregnancy
COIS- The authors declare no competing interests.
EDAT- 2023/04/06 06:00
MHDA- 2023/04/07 12:42
PMCR- 2023/04/05
CRDT- 2023/04/05 23:44
PHST- 2022/10/20 00:00 [received]
PHST- 2023/03/29 00:00 [accepted]
PHST- 2023/04/07 12:42 [medline]
PHST- 2023/04/05 23:44 [entrez]
PHST- 2023/04/06 06:00 [pubmed]
PHST- 2023/04/05 00:00 [pmc-release]
AID - 10.1186/s12884-023-05555-z [pii]
AID - 5555 [pii]
AID - 10.1186/s12884-023-05555-z [doi]
PST - epublish
SO  - BMC Pregnancy Childbirth. 2023 Apr 5;23(1):232. doi: 10.1186/s12884-023-05555-z.