Archives of Women's Mental Health

, Volume 12, Issue 2, pp 105–112

Tailoring screening protocols for perinatal depression: prevalence of high risk across obstetric services in Western Australia

  • Janette Brooks
  • Elizabeth Nathan
  • Craig Speelman
  • Delphin Swalm
  • Angela Jacques
  • Dorota Doherty
Original Contribution


Given what appears to be an ever-increasing list of concerning consequences of perinatal depression, longitudinal studies have much to offer when considering the timing and efficacy of prevention and intervention strategies. The course of depressive symptomatology across the perinatal period at four obstetric services was investigated utilising Western Australian data collected as part of the beyondblue National Postnatal Depression Program. Pregnant women completed one or two Edinburgh Postnatal Depression Scale (EPDS) assessments during pregnancy and a demographic and psychosocial risk factors questionnaire. One or two EPDS assessments were administered within 12 months postpartum. Prevalence of high risk scores across gestational ages ranged from 14% to 5% during pregnancy and 6% to 9% in the postnatal period. For women who were screened twice, the prevalence of high risk scores appeared earlier and decreased with advancing gestation (p = 0.026). The prevalence of postnatal high risk increased after 12 weeks postpartum (p = 0.029). Screening protocols for depressive symptomatology during pregnancy may need to be fine-tuned across individual hospitals, and take into account gestational ages, in order to be most effective. As depressive symptomatology persists postnatally, screening protocols may need to extend beyond 12 weeks postpartum.


Perinatal depression Psychosocial screening 


  1. Austin M-P, Lumley J (2003) Antenatal screening for postnatal depression: a systematic review. Acta Pschiatr Scand 107:10–17CrossRefGoogle Scholar
  2. Bennet HA, Einarson A, Taddio A, Loren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103:698–709Google Scholar
  3. Bishop LM (2002) Coping with postnatal depression: a personal perspective. Med J Aust 177:S106PubMedGoogle Scholar
  4. Boyce P (1994) Personality dysfunction, marital problems and postnatal depression. In: Cox J, Holden J (eds) Perinatal psychiatry—use and misuse of the edinburgh postnatal depression scale. Gaskell, London, pp 82–102Google Scholar
  5. Buist A, Barnett B, Milgrom J, Pope S, Condon J, Ellwood D et al (2002) To screen or not to screen—that is the question in perinatal depression. Med J Aust 177:S101–S105PubMedGoogle Scholar
  6. Buist A, Bilszta J, Barnett B, Milgrom J, Ericksen J, Condon J et al (2005) Recognition and management of perinatal depression in general practice: a survey of GPs and postnatal women. Aust Fam Physician 34:787–790PubMedGoogle Scholar
  7. Cox J, Holden J, Sagovsky R (1987) Detection of postnatal depression: development of the 10 item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786PubMedCrossRefGoogle Scholar
  8. Evans J, Heron J, Francomb H (2001) Cohort study of depressed mood during pregnancy and after childbirth. Br Med J 323:257–260CrossRefGoogle Scholar
  9. Fergusson D, Horwood J, Thorpe K, ALSPAC Study Team (1996) Changes in depression during and following pregnancy. Paediatr perinat epidemiol 10:279–293PubMedCrossRefGoogle Scholar
  10. Gotlib IH, Whiffen V, Mount JH, Milne K, Cordy NI (1989) Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consul Clin Psychol 57:269–274CrossRefGoogle Scholar
  11. Grace SL, Evindar A, Stewart DE (2003) The effect of postpartum depression on child cognitive development and behaviour: a review and critical analysis of the literature. Arch Women Ment Health 6:263–274CrossRefGoogle Scholar
  12. Green J, Murray D (1994) The use of the Edinburgh Postnatal Depression Scale in research to explore the relationship between antenatal and postnatal dysphoria. In: Cox JL, Holden J (eds) Perinatal psychiatry: Use and abuse of the edinburgh postnatal depression scale. Gaskell, London, pp 180–198Google Scholar
  13. Hammen C (2003) Social stress and women’s risk for recurrent depression. Arch Women Ment Health 6:9–13CrossRefGoogle Scholar
  14. Harvey I, McGrath G (1988) Psychiatric morbidity in spouses of women admitted to a mother and baby unit. Br J Psychiatry 152:506–510PubMedCrossRefGoogle Scholar
  15. Horowitz JA, Goodman J (2004) A longitudinal study of maternal postpartum depression symptoms. Res Theory Nurs Pract 18:149–163PubMedCrossRefGoogle Scholar
  16. Josefsson A, Berg G, Nordin C, Sydsjo G (2001) Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 80:251–255PubMedCrossRefGoogle Scholar
  17. Kumar R, Robson KM (1984) A prospective study of emotional disorders in childbearing women. Br J Psychiatry 144:35–47PubMedCrossRefGoogle Scholar
  18. Lovestone S, Kumar R (1993) Postnatal psychiatric illness: the impact on partners. Br J Psychiatry 163:210–216PubMedCrossRefGoogle Scholar
  19. Morgan M, Matthey S, Barnett B, Richardson C (1997) A group programme for postnatally distressed women and their partners. J Adv Nurs 28:913–920CrossRefGoogle Scholar
  20. Phillips LHC, O’Hara MW (1991) Prospective study of postpartum depression: 4 1/2-year follow-up of women and children. J Ab Psychol 100:151–155CrossRefGoogle Scholar
  21. Rubertsson C, Waldenstrom U, Wickberg B, Radestad I, Hildingsson I (2005) Depressive mood in early pregnancy and postpartum: prevalence and women at risk in a national Swedish sample. J Reprod Infant Psychol 23:155–166CrossRefGoogle Scholar
  22. Watson JP, Elliott SA, Rugg AJ, Brough DI (1984) Psychiatric disorder in pregnancy and the first postnatal year. Br J Psychiatry 144:453–462PubMedCrossRefGoogle Scholar
  23. Wolkind S, Coleman EZ, Ghodsian M (1980) Continuities in maternal depression. Int J Fam Psychiatr 1:167–181Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Janette Brooks
    • 1
  • Elizabeth Nathan
    • 2
  • Craig Speelman
    • 3
  • Delphin Swalm
    • 4
  • Angela Jacques
    • 2
  • Dorota Doherty
    • 5
  1. 1.Western Australian Perinatal Mental Health UnitSubiacoAustralia
  2. 2.Women’s and Infant’s Research Foundation Inc.King Edward Memorial HospitalSubiacoWestern Australia
  3. 3.School of Psychology and Social ScienceEdith Cowan UniversityJoondalupWestern Australia
  4. 4.SubiacoWestern Australia
  5. 5.School of Women’s and Infants HealthUniversity of Western Australia, King Edward Memorial HospitalSubiacoWestern Australia

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