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Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis

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Abstract

Purpose

To compare the predictive validity of the Edinburgh Postnatal Depression Scale (EPDS) and other tools for screening depression in pregnant and postpartum women through a systematic review and meta-analysis.

Methods

An electronic search of MEDLINE, EMBASE, CINAHL, and PsycArticles databases was conducted using the following keywords: depression, perinatal-related terms, and EPDS. Quality Assessment of Diagnostic Accuracy Studies-2 was used to assess the risk of bias in diagnostic studies.

Results

The search identified 823 articles, of which 17 studies met the inclusion criteria. In 1831 pregnant women from nine studies, pooled sensitivity and specificity of the EPDS were 0.81 and 0.87, respectively, with summary receiver operating characteristic (sROC) curve of 0.90. In 515 postpartum women from six studies, pooled sensitivity, specificity, and sROC were 0.79, 0.92, and 0.90, respectively. We then compared the EPDS with other tools using three or more studies. The sROC curve of the Patient Health Questionnaire-9 was 0.74, which was lower than that (0.86) of the EPDS. The sROC curve of the Beck Depression Inventory and the ten-item Kessler Psychological Distress Scale was 0.91, similar to that of the EPDS (0.90 and 0.87). However, in comparison with the Postpartum Depression Screening Scale (0.98), the sROC curve of the EPDS was 0.54.

Conclusion

As a tool specialized for screening depression in pregnant and postpartum women, the EPDS showed excellent performance. Thus, the EPDS can be used in preference to other tools to screen for depression in perinatal women at a primary care setting or a midwifery center.

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Funding

This work was supported by the Soonchunhyang University Research Fund. And this study was accomplished relating to searching causes of preterm birth by a grant by a grant (NRF 2019R1F1A104579912) of the Basic Science Research Program through the National Research Foundation (NRF) funded by the Ministry of Education, Republic of Korea. The funder had no further role in the conduct of the research.

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Authors and Affiliations

  1. School of Nursing, Soonchunhyang University, Cheonan, Korea

    Seong-Hi Park

  2. School of Nursing, Soonchunhyang University, 31 Soonchunhyang 6-gil, Dongnam-gu, Cheonan, 31151, Chungcheongnam-do, Korea

    Jeung-Im Kim

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All authors (SHP and JIK) contributed to the study’s conception and design, material preparation, data collection and analysis. Advanced analysis was performed by SHP. All authors have written the first draft of the manuscript and commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jeung-Im Kim.

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Park, SH., Kim, JI. Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Arch Gynecol Obstet 307, 1331–1345 (2023). https://doi.org/10.1007/s00404-022-06525-0

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