Postpartum depression screening and pelvic floor symptoms among women referred to a specialty postpartum perineal clinic - 01/03/18
, Julia A. DePorre, MD, Jessica K. Haefner, BS, Mitchell B. Berger, MD, PhD, Dee E. Fenner, MDAbstract |
Background |
Postpartum depression and pelvic floor disorders are both common conditions that affect women; however, the association between the 2 has yet to be determined.
Objective |
The aims of our study are to: (1) determine the prevalence of a positive postpartum depression screen in a specialty postpartum perineal clinic, and (2) identify risk factors for postpartum depression in this population.
Study Design |
A retrospective chart review was performed of 294 women referred to a specialty postpartum perineal clinic at the University of Michigan from March 30, 2012, through May 3, 2016. Women who completed a new patient intake form, including the Edinburgh Postnatal Depression Scale, were included. The prevalence of a positive Edinburgh Postnatal Depression Scale screen (≥10) was determined. Bivariate analyses were used to compare demographics, delivery characteristics, referral indications, and postpartum pelvic floor symptoms between women with and without a positive Edinburgh Postnatal Depression Scale screen. Significant variables identified in the analyses were then used to perform logistic regression to identify factors independently associated with a positive Edinburgh Postnatal Depression Scale screen.
Results |
In all, 15.6% (46/294) of women had a positive postpartum depression screen. Average age was 30.6 ± 4.8 years, average body mass index was 28.9 ± 5.06 kg/m2, 68.0% (200/294) were Caucasian, 79.6% (234/294) were primiparous, and 86.0% (245/285) were breast-feeding. Using multivariable logistic regression, women with a positive postpartum depression screen had higher odds of being non-Caucasian (adjusted odds ratio, 2.72; 95% confidence interval, 1.27–5.832; P = .01), having a history of depression and/or anxiety (adjusted odds ratio, 2.77; 95% confidence interval, 1.23–6.24; P = .01), having been referred for pain (adjusted odds ratio, 2.61; 95% confidence interval, 1.24–5.49; P = .01), and reporting urinary incontinence during and after pregnancy (adjusted odds ratio, 3.81; 95% confidence interval, 1.57–9.25; P = .003).
Conclusion |
Urinary incontinence during and after pregnancy and referral for pain were pelvic floor symptoms independently associated with a positive postpartum depression screen in women referred to a specialty perineal clinic. Therefore, consideration should be given to depression screening in women presenting with perinatal urinary incontinence and persistent postpartum pain, as these women may be at increased risk of developing postpartum depression.
Le texte complet de cet article est disponible en PDF.Key words : anal incontinence, dyspareunia, Edinburgh Postnatal Depression Scale, fecal incontinence, obstetric anal sphincter laceration, pelvic pain, perineal pain, postpartum depression, postpartum pain, urinary incontinence
Plan
| Dr DePorre is now affiliated with St. Joseph Mercy Ann Arbor, Ann Arbor, MI. |
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| Investigator support for Dr Swenson was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Women’s Reproductive Health Research Career Development Award K12 HD065257. The National Institutes of Health did not play a role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. |
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| The authors report no conflict of interest. |
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| Cite this article as: Swenson CW, DePorre JA, Haefner JK, et al. Postpartum depression screening and pelvic floor symptoms among women referred to a specialty postpartum perineal clinic. Am J Obstet Gynecol 2018;218:335.e1-6. |
Vol 218 - N° 3
P. 335.e1-335.e6 - mars 2018 Retour au numéro
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