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Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study
BACKGROUND: Postpartum depression (PPD) is a severe mental disorder that often results in poor maternal-infant attachment and negatively impacts infant development. Universal screening has recently been recommended to identify women at risk, but the optimal screening time during pregnancy has not be...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709910/ https://www.ncbi.nlm.nih.gov/pubmed/34890349 http://dx.doi.org/10.2196/26665 |
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author | Haßdenteufel, Kathrin Lingenfelder, Katrin Schwarze, Cornelia E Feisst, Manuel Brusniak, Katharina Matthies, Lina Maria Goetz, Maren Wallwiener, Markus Wallwiener, Stephanie |
author_facet | Haßdenteufel, Kathrin Lingenfelder, Katrin Schwarze, Cornelia E Feisst, Manuel Brusniak, Katharina Matthies, Lina Maria Goetz, Maren Wallwiener, Markus Wallwiener, Stephanie |
author_sort | Haßdenteufel, Kathrin |
collection | PubMed |
description | BACKGROUND: Postpartum depression (PPD) is a severe mental disorder that often results in poor maternal-infant attachment and negatively impacts infant development. Universal screening has recently been recommended to identify women at risk, but the optimal screening time during pregnancy has not been defined so far. Thus, web-based technologies with widespread use among women of childbearing age create new opportunities to detect pregnancies with a high risk for adverse mental health outcomes at an early stage. OBJECTIVE: The aim of this study was to stratify the risk for PPD and to determine the optimal screening time during pregnancy by using a web-based screening tool collecting electronic patient-reported outcomes (ePROs) as the basis for a screening algorithm. METHODS: In total, 214 women were repeatedly tested for depressive symptoms 5 times during and 3 times after pregnancy by using the Edinburgh Postnatal Depression Scale (EPDS), accessible on a web-based pregnancy platform, developed by the authors of this study. For each prenatal assessment, the area under the curve (AUC), sensitivity, specificity, and predictive values for PPD were calculated. Multivariate logistic regression analyses were applied to identify further potential predictors, such as age, education, parity, relationship quality, and anxiety, to increase predictive accuracy. RESULTS: Digitally collected data from 214 pregnant women were analyzed. The predictive accuracy of depressive symptoms 3 and 6 months postpartum was reasonable to good regarding the screening in the second (AUC=0.85) and third (AUC=0.75) trimester. The multivariate logistic regression analyses resulted in an excellent AUC of 0.93 at 3 months and a good AUC of 0.87 at 6 months postpartum. CONCLUSIONS: The best predictive accuracy for PPD has been shown for screening between the 24th and the 28th gestational week (GW) and seems to be beneficial for identifying women at risk. In combination with the aforementioned predictive factors, the discriminatory power improved, particularly at 3 months postpartum. Screening for depression during pregnancy, combined with the women’s personal risk profile, can be used as a starting point for developing a digital screening algorithm. Thereby, web-based assessment tools constitute feasible, efficient, and cost-effective approaches. Thus, they seem to be beneficial in detecting high-risk pregnancies in order to improve maternal and infant birth outcomes in the long term. |
format | Online Article Text |
id | pubmed-8709910 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-87099102022-01-10 Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study Haßdenteufel, Kathrin Lingenfelder, Katrin Schwarze, Cornelia E Feisst, Manuel Brusniak, Katharina Matthies, Lina Maria Goetz, Maren Wallwiener, Markus Wallwiener, Stephanie JMIR Ment Health Original Paper BACKGROUND: Postpartum depression (PPD) is a severe mental disorder that often results in poor maternal-infant attachment and negatively impacts infant development. Universal screening has recently been recommended to identify women at risk, but the optimal screening time during pregnancy has not been defined so far. Thus, web-based technologies with widespread use among women of childbearing age create new opportunities to detect pregnancies with a high risk for adverse mental health outcomes at an early stage. OBJECTIVE: The aim of this study was to stratify the risk for PPD and to determine the optimal screening time during pregnancy by using a web-based screening tool collecting electronic patient-reported outcomes (ePROs) as the basis for a screening algorithm. METHODS: In total, 214 women were repeatedly tested for depressive symptoms 5 times during and 3 times after pregnancy by using the Edinburgh Postnatal Depression Scale (EPDS), accessible on a web-based pregnancy platform, developed by the authors of this study. For each prenatal assessment, the area under the curve (AUC), sensitivity, specificity, and predictive values for PPD were calculated. Multivariate logistic regression analyses were applied to identify further potential predictors, such as age, education, parity, relationship quality, and anxiety, to increase predictive accuracy. RESULTS: Digitally collected data from 214 pregnant women were analyzed. The predictive accuracy of depressive symptoms 3 and 6 months postpartum was reasonable to good regarding the screening in the second (AUC=0.85) and third (AUC=0.75) trimester. The multivariate logistic regression analyses resulted in an excellent AUC of 0.93 at 3 months and a good AUC of 0.87 at 6 months postpartum. CONCLUSIONS: The best predictive accuracy for PPD has been shown for screening between the 24th and the 28th gestational week (GW) and seems to be beneficial for identifying women at risk. In combination with the aforementioned predictive factors, the discriminatory power improved, particularly at 3 months postpartum. Screening for depression during pregnancy, combined with the women’s personal risk profile, can be used as a starting point for developing a digital screening algorithm. Thereby, web-based assessment tools constitute feasible, efficient, and cost-effective approaches. Thus, they seem to be beneficial in detecting high-risk pregnancies in order to improve maternal and infant birth outcomes in the long term. JMIR Publications 2021-12-10 /pmc/articles/PMC8709910/ /pubmed/34890349 http://dx.doi.org/10.2196/26665 Text en ©Kathrin Haßdenteufel, Katrin Lingenfelder, Cornelia E Schwarze, Manuel Feisst, Katharina Brusniak, Lina Maria Matthies, Maren Goetz, Markus Wallwiener, Stephanie Wallwiener. Originally published in JMIR Mental Health (https://mental.jmir.org), 10.12.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Haßdenteufel, Kathrin Lingenfelder, Katrin Schwarze, Cornelia E Feisst, Manuel Brusniak, Katharina Matthies, Lina Maria Goetz, Maren Wallwiener, Markus Wallwiener, Stephanie Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study |
title | Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study |
title_full | Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study |
title_fullStr | Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study |
title_full_unstemmed | Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study |
title_short | Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study |
title_sort | evaluation of repeated web-based screening for predicting postpartum depression: prospective cohort study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709910/ https://www.ncbi.nlm.nih.gov/pubmed/34890349 http://dx.doi.org/10.2196/26665 |
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