Use of an educational intervention to increase screening for antenatal depression in an obstetrics and gynecology practice

ABSTRACT Background: Depression affects approximately 12% of pregnant women and increases maternal and fetal risk during pregnancy and the postpartum period. The United States Preventative Services Task Force and the American College of Obstetricians and Gynecologists recommend that all prenatal care include depression screening. This study assessed the effectiveness of an educational intervention to increase screening for depression during prenatal care. Local problem: The clinical site serves a socioeconomically and culturally high-risk population. Prior to the intervention, prenatal depression screening was not incorporated into prenatal care. Methods: Health records of patients presenting for prenatal care to an obstetrics and gynecology clinic were analyzed before an educational intervention on prenatal depression was delivered to providers at the practice site. Data for prenatal depression screening rates, treatment plans, and patient demographic information were extracted and compared to determine compliance with antenatal depression screening guidelines. Interventions: The primary intervention of this initiative is the provision of education on the importance of and techniques for prenatal depression screening, diagnosis, and treatment. Results: Prenatal depression screening increased from 0% to 27% of patients following the intervention. No significant correlation was found between factors of age, gestational age, gravidity, parity, or marital status. A total of 2.8% of screened patients scored positive for severe depression, 5.7% indicated moderate depression, and 51% indicated mild depression. Conclusions: Education and training improves provision of prenatal depression screening, but further work is needed to improve the accurate and timely identification of depression, as well as its appropriate treatment, referral, and follow-up.