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...

Full description

Saved in:
Bibliographic Details
Main Authors: Allison Chu, Alexis French, Sarah Dotters-Katz, John Nathan Copeland, Gary Maslow
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:npj Women's Health
Online Access:https://doi.org/10.1038/s44294-025-00067-x
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850045622341599232
author Allison Chu
Alexis French
Sarah Dotters-Katz
John Nathan Copeland
Gary Maslow
author_facet Allison Chu
Alexis French
Sarah Dotters-Katz
John Nathan Copeland
Gary Maslow
author_sort Allison Chu
collection DOAJ
description 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.
format Article
id doaj-art-bc6142bf461f40a0a0937da99eb7a886
institution DOAJ
issn 2948-1716
language English
publishDate 2025-02-01
publisher Nature Portfolio
record_format Article
series npj Women's Health
spelling doaj-art-bc6142bf461f40a0a0937da99eb7a8862025-08-20T02:54:39ZengNature Portfolionpj Women's Health2948-17162025-02-01311710.1038/s44294-025-00067-xUnderstanding and addressing antenatal depression management in the high risk obstetrics care settingAllison Chu0Alexis French1Sarah Dotters-Katz2John Nathan Copeland3Gary Maslow4Duke University School of MedicineDuke University Department of Psychiatry and Behavioral SciencesDuke University Department of Obstetrics and Gynecology, Division of Maternal Fetal MedicineDuke University Department of Psychiatry and Behavioral SciencesDuke University Department of Psychiatry and Behavioral SciencesAbstract 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.https://doi.org/10.1038/s44294-025-00067-x
spellingShingle Allison Chu
Alexis French
Sarah Dotters-Katz
John Nathan Copeland
Gary Maslow
Understanding and addressing antenatal depression management in the high risk obstetrics care setting
npj Women's Health
title Understanding and addressing antenatal depression management in the high risk obstetrics care setting
title_full Understanding and addressing antenatal depression management in the high risk obstetrics care setting
title_fullStr Understanding and addressing antenatal depression management in the high risk obstetrics care setting
title_full_unstemmed Understanding and addressing antenatal depression management in the high risk obstetrics care setting
title_short Understanding and addressing antenatal depression management in the high risk obstetrics care setting
title_sort understanding and addressing antenatal depression management in the high risk obstetrics care setting
url https://doi.org/10.1038/s44294-025-00067-x
work_keys_str_mv AT allisonchu understandingandaddressingantenataldepressionmanagementinthehighriskobstetricscaresetting
AT alexisfrench understandingandaddressingantenataldepressionmanagementinthehighriskobstetricscaresetting
AT sarahdotterskatz understandingandaddressingantenataldepressionmanagementinthehighriskobstetricscaresetting
AT johnnathancopeland understandingandaddressingantenataldepressionmanagementinthehighriskobstetricscaresetting
AT garymaslow understandingandaddressingantenataldepressionmanagementinthehighriskobstetricscaresetting