Webster et al developed a predictive index to screen for postnatal depression. This can help to identify a patient who may benefit from more aggressive management. The authors are from Royal Women’s Hospital and Griffith University in Brisbane, Queensland, Australia.
Outcome: postnatal depression as measured by the Edinburgh Postpartum Depression Scale
Parameters for antenatal measures:
(1) Maternity Social Support Scale score (from 6 to 30)
(2) family history of mood disorder
(3) history of postnatal depression for the woman’s mothe
(4) past history of postnatal depression
(5) past psychiatric history
Parameters for postnatal measures (on day 3 or discharge):
(1) Maternity Social Support Scale score (from 6 to 30)
(2) satisfaction with delivery on the Royal Women’s Hospital Patient Satisfaction Form (1 low, 5 high)
(3) Blues score of Grover et al (from 0 to 11)
(4) Brisbane Mother Baby scale score (from 15 to 75)
|
Parameter |
Finding |
Points |
|
antenatal maternity social support scale score |
< 25 |
0 |
|
|
>= 25 |
1 |
|
family history of mood disorder |
no |
0 |
|
|
yes |
1 |
|
history of postnatal depression in woman’s mother |
no |
0 |
|
|
yes |
2 |
|
past history of postnatal depression |
no |
0 |
|
|
yes |
3 |
|
past psychiatric history |
no |
0 |
|
|
yes |
3 |
|
maternity social support scale score |
< 25 |
0 |
|
|
>= 25 |
2 |
|
satisfaction with delivery |
1 to 3 |
0 |
|
|
4 or 5 |
2 |
|
Blues score |
< 8 |
0 |
|
|
>= 8 |
3 |
|
Brisbane Mother Baby Scale |
<= 30 |
0 |
|
|
> 30 |
4 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum antenatal subscore: 10
• maximum postnatal subscore: 11
• maximum score: 21
• A score > 8 was associated with a 50% chance of postnatal depression.
• A score > 3 had a 33% chance of postnatal depression
Performance:
• A cutoff of 3 had a sensitivity of 66% and specificity of 79%, with a negative predictive value of 94%.
• A cutoff of 8 had a sensitivity of 20% and specificity of 96%.
Specialty: Psychiatry
