Are there specific antepartum factors and labor complications that predict elevated immediate postpartum Edinburgh Postpartum Depression Scale scores?

Abstract

Background: Postpartum depression is a common medical condition diagnosed in the weeks after delivery. There are several modifiable risk factors during the antepartum, labor and delivery, and immediate postpartum periods that may influence the likelihood that an individual will develop this condition. Objective: The purpose of this study was to identify risk factors that may predict an individual’s risk of developing postpartum depression. Methods: We conducted a retrospective cohort study of all deliveries over a 14 month period. Demographic characteristics and complications during pregnancy and delivery were obtained from the electronic medical record. The Edinburg Perinatal Depression Scale (EPDS) was administered to all postpartum women before discharge. Antenatal and delivery characteristic associations with EPDS cutoffs of ≥10 and ≥13 were determined and significant variables were included in a logistic regression to determine predictive factors for elevated immediate postpartum EPDS scores. Results: A total of 1,913 women had valid immediate postpartum EPDS results. Women with a history of depression, those with a positive drug screen on admission to labor and delivery, those with babies admitted to the neonatal intensive care unit (NICU), and those with alcohol or opioid abuse were found to have increased risk of development of PPD. Logistic regression analysis found that having a positive drug screen (OR 2.54, 95% CI 1.43-4.52) history of depression (OR 3.97, 95% CI 2.44-6.30), alcohol use (OR 5.30, 95% CI 1.39-20.16), and opioid use disorder (OR 8.64, 95% CI 1.06-70.49) predicted EPDS scores ≥10, while having a baby admitted to the NICU (OR 1.70, 95% CI 1.20-2.57), history of depression (OR 4.46, 95% CI 2.81-7.07), opioid use disorder (OR 9.32, 95% CI 1.14-76.39) predicted EPDS scores ≥13. Conclusion: Several modifiable risk factors were found that could lead to an increased risk of PPD. Early screening and intervention based on risk factors may decrease the likelihood of developing early postpartum depression.