The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60597

Lee Chaix McDonough, MSW, MSPH, University of North Carolina at Chapel Hill, 7214 Snowden Crest, San Antonio, TX 78240-4794, 210-615-7484, lcmcdonough@excite.com and Cynthia H. Cassell, MA, School of Public Health, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445.

Background: Approximately ten to fourteen percent of pregnant women experience depression during pregnancy. Adverse health outcomes for mother and infant include increased risk of premature delivery, operative deliveries, fetal growth retardation, poor mother-infant attachment, and additional depressive episodes during future pregnancies. However, obstetricians and gynecologists (OB/GYNs) significantly underreport perinatal depression, partly due to ineffective or absent screening procedures. The aim of this study is to assess OB/GYN’s level of comfort in screening for and managing depression in pregnant women. Methods: Questionnaires regarding comfort level, previous training, and experience with diagnosing depression in pregnant women were administered to OB/GYN residents and attending physicians at three residency programs in North Carolina. Semi-structured interviews were conducted at each site to determine current screening procedures and training goals. Results: Overall, OB/GYN attending physicians were more comfortable screening, diagnosing, and managing pregnant women with depression than residents. Residents with previous experience in behavioral medicine were more comfortable than residents with little or no previous experience. Most respondents agreed that additional training in perinatal depression screening is necessary. No program had a standardized protocol for perinatal depression screening nor did they regularly use diagnostic instruments during pregnancy. Conclusions: Additional training in screening for perinatal depression is needed by OB/GYN residents and attending physicians. Screening can be improved by: 1) providing training in behavioral medicine and among public health practitioners; 2) implementing an explicit screening protocol; and 3) using instruments designed specifically for pregnant women. Development of such an instrument, increased training, and future research in this area is warranted.

Learning Objectives:

Learning Objectives: Perinatal depression has yet to receive enough attention from public health professionals, especially given the health implications for both women and infants. By presenting these findings at the American Public Health Association Annual Meeting, we aim to emphasize the need for additional research and increased advocacy and awareness of perinatal depression. The results of this study provide the basis for four key learning objectives. At the conclusion of our presentation, the participant will be able to:
• Describe current screening procedures and instruments for depression in women of reproductive age;
• Assess the strengths and limitations of current perinatal screening practices;
• Identify barriers to resident training in screening for, managing, and treating depression in women of reproductive age, including pregnant women; and
• Advocate for increased training in behavioral medicine for OB/GYN residents and for improved screening procedures for diagnosing depression and/or anxiety in pregnant women.

Keywords: Prenatal Interventions, Depression

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.