Understanding and addressing antenatal depression management in the high risk obstetrics care setting
Abstract Obstetricians have both an obligation and opportunity to manage mental health disorders in pregnancy. We aimed to characterize existing screening and management practices and to recommend systems-level solutions to address gaps in perinatal depression care. In this retrospective cohort stud...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-02-01
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| Series: | npj Women's Health |
| Online Access: | https://doi.org/10.1038/s44294-025-00067-x |
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| Summary: | Abstract Obstetricians have both an obligation and opportunity to manage mental health disorders in pregnancy. We aimed to characterize existing screening and management practices and to recommend systems-level solutions to address gaps in perinatal depression care. In this retrospective cohort study of 5313 patients, 1421 had any PHQ-9 screen during pregnancy. In 76 pregnancy episodes of patients who had a positive depression screen (PHQ-9 score ≥ 10), 81.6% (n = 62) of screenings were completed in the first trimester and interventions were provided for 65.8% (n = 50). Antidepressants were started in 11 pregnancies; of those, 54.5% (n = 6) and 90.9% (n = 10) did not have a validated screening at the time of starting medication and during follow-up, respectively. The study revealed gaps in utilization of validated tools to identify and manage perinatal depression and highlights the need for improved partnerships between obstetricians and psychiatric specialists. Adapting the collaborative care model to address the unique needs of high-risk obstetric patients emerges as a potential solution. |
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| ISSN: | 2948-1716 |