(#67) Understanding the Optimal Timeline of Edinburgh Postnatal Depression Scale Administration During Hospital Admission

Abstract: Background: Postpartum depression (PPD) affects about one in seven people in the U.S. annually. The Edinburgh Postnatal Depression Scale (EPDS) is used to screen for PPD. PPD incidence peaks 4 to 6 weeks postpartum; therefore, monitoring during postpartum visits is essential. About 40% of patients do not attend postpartum visits, leading many hospitals to provide perinatal screening with EPDS. However, the most advantageous time to administer the EPDS has not been established. Many patients are evaluated immediately after delivery, when factors such as pain could affect responses. We propose administering EPDS ≥24 hours after delivery to better identify patients most at risk of developing PPD. Methods: Review of published literature via PubMed using the keywords "(Edinburgh Postpartum Depression Scale OR EPDS OR Postpartum Depression OR PPD) AND (perinatal OR immediate postpartum OR delivery admission)." Initial search yielded 1,206 articles, which were refined to 21 of the most relevant. Results: Most literature suggests that evaluation 24 to 96 hours after delivery can predict a patient's EPDS score 4 to 6 weeks postpartum. One study found that EPDS administration 24 hours after delivery does not reliably predict future depression. Conclusion: Although evaluation of PPD 4 to 6 weeks postpartum is ideal, evaluating patients during delivery admission allows for monitoring of higher risk patients, but may be unreliable if administered 24 hours after delivery. Although additional research is needed, current evidence suggests that assessing patients ≥24 hours after delivery yields the most accurate predictions of PPD using EPDS.

Short Description: We have noticed that many patients are administered the Edinburgh Postnatal Depression Scale (EPDS) within hours of delivery, when factors such as pain can affect responses. This literature review aims to address the optimal time to administer the EPDS during hospital admission for delivery.

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