Antenatal identification of major depressive disorder: a cohort study - 21/11/12
, Andrea S. Chambers, PhD b, Dana Steidtmann, PhD b, Esther Tsai, BS b, Aaron B. Caughey, MD, PhD c, Amy Wong, MD d, Rachel Manber, PhD b
Reprints: Deirdre J. Lyell, MD, 300 Pasteur Dr, HH333 MC5317, Palo Alto, CA 94304Résumé |
Objective |
The purpose of this study was to estimate the frequency of identification of major depressive disorder by providers during prenatal care.
Study Design |
A cohort of pregnant women who were participating in a randomized controlled trial and who had received a diagnosis of major depressive disorder was examined. Women were included in the current study if prenatal clinic records were available and legible.
Results |
Clinical depression was noted in 56% of prenatal charts and on 24% of problem lists. Physicians and certified nurse midwives noted depression equally (P = .935); physicians more frequently noted mental health referral (23% vs 0%; P = .01), and midwives more frequently included depression on the problem list (P = .01). Recent medication use, which was stopped before conception or study participation, predicted notation of depression in the chart (P = .001).
Conclusion |
Depression frequently is missed during pregnancy and, when identified, is underacknowledged as a problem. Women who have not recently used antidepressant medication are more likely to be missed. Better screening and acknowledgment are needed.
Le texte complet de cet article est disponible en PDF.Key words : depression, major depressive disorder, pregnancy, prenatal care, screening
Plan
| Supported by grant number HS09988 from the Agency for Healthcare Research and Quality. |
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| The authors report no conflict of interest. |
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| Cite this article as: Lyell DJ, Chambers AS, Steidtmann D, et al. Antenatal identification of major depressive disorder: a cohort study. Am J Obstet Gynecol 2012;207:506.e1-6. |
Vol 207 - N° 6
P. 506.e1-506.e6 - décembre 2012 Retour au numéro
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