Positive antenatal Edinburgh Depression Scale: examining behavioral and pharmacological therapy on maternal and neonatal outcomes

Abstract

Objective: We hypothesized that women with a positive antenatal Edinburgh Depression Screen (EPDS) (≥10), undergoing behavioral or pharmacologic therapy have improved maternal and neonatal outcomes.Study design: This is a retrospective study of singleton pregnancies at UC, San Diego from 2010 to 2014. Patients with an antenatal EPDS were subdivided based on their intervention: negative score, positive score no treatment, behavioral therapy only, and pharmacologic therapy. The primary outcome was rate of preterm birth with secondary outcomes of maternal and neonatal outcomes.Results: Patients with a positive EPDS had a higher rate of preterm delivery, small-for-gestational age, NICU admission and Apgar score <7. Rates of adverse outcomes were highest among women receiving pharmacologic therapy. Rates of adverse outcomes women were not increased in the behavioral therapy group compared to the negative EPDS group. When adjusting for confounding variables, patient with a positive EPDS were more likely deliver preterm with an adjusted odds ratio of 1.71. Among varying treatment modalities, the odds ratio for preterm delivery was not statistically significant.Conclusion: Adverse pregnancy outcomes were highest among those requiring pharmacotherapy. Behavioral therapy had a positive effect on outcomes. Intervention to reduce these adverse outcomes in these patients needs further study.

Keywords: Behavioral therapy; Edinburgh Postnatal Depression Scale; perinatal depression; pharmacologic therapy; preterm delivery.