Association Between Postpartum Depression Symptoms and Social Determinants of Health in Outpatient Pediatric Clinic

Kathleen Wilson; Pablo Martínez-Camblor; Kimberly Gifford; Mary Kay Jankowski

doi:10.1016/j.pedhc.2024.08.007

Association Between Postpartum Depression Symptoms and Social Determinants of Health in Outpatient Pediatric Clinic

J Pediatr Health Care. 2024 Nov-Dec;38(6):812-822. doi: 10.1016/j.pedhc.2024.08.007. Epub 2024 Sep 19.

Authors

Kathleen Wilson¹, Pablo Martínez-Camblor², Kimberly Gifford³, Mary Kay Jankowski⁴

Affiliations

¹ Geisel School of Medicine at Dartmouth, Hanover, NH. Electronic address: [email protected].
² Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH.
³ Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH.
⁴ Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Psychiatry, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH.

PMID: 39297831
DOI: 10.1016/j.pedhc.2024.08.007

Abstract

Introduction: We aimed to (1) identify the prevalence of postpartum depression (PPD) symptoms using the Patient Health Questionnaire-2 (PHQ-2) and the Edinburgh Postnatal Depression Scale (EPDS), and (2) analyze the relationship between PPD symptoms and social determinants of health (SDoH).

Method: We obtained data from 1327 infant/mother dyads at 1 and 6-month well-child checks. We used Chi-square and T-tests to compare social determinants between PPD screening groups and logistical regression to construct predictive models for PPD.

Results: The prevalence of positive PPD screens was 5-7%, but only 1.85% screened positive at both periods. Although the EPDS and PHQ-2 were correlated (Pearson 0.66), the PHQ-2 missed 65% of those identified by the EPDS. Positive PPD screens were associated with greater SDoH concerns.

Discussion: Our study highlights the importance of repeated PPD screening. The EPDS detected more mothers at risk than the PHQ-2. Multiple SDoH were associated with PPD symptoms.

Keywords: Edinburgh Postnatal Depression Scale; Patient Health Questionnaire-2; Postnatal depression; Social Determinants of Health (SDOH).

MeSH terms

Adult
Ambulatory Care Facilities
Depression, Postpartum* / diagnosis
Depression, Postpartum* / epidemiology
Depression, Postpartum* / psychology
Female
Humans
Infant
Mass Screening / methods
Mothers / psychology
Mothers / statistics & numerical data
Prevalence
Psychiatric Status Rating Scales
Social Determinants of Health*
Surveys and Questionnaires