Antenatal identification of major depressive disorder: a cohort study
Abstract
Objective The purpose of this study was to estimate the frequency of identification of major depressive disorder by providers during prenatal care.Study design A cohort of pregnant women who were participating in a randomized controlled trial and who had received a diagnosis of major depressive disorder was examined. Women were included in the current study if prenatal clinic records were available and legible.Results Clinical depression was noted in 56% of prenatal charts and on 24% of problem lists. Physicians and certified nurse midwives noted depression equally (P = .935); physicians more frequently noted mental health referral (23% vs 0%; P = .01), and midwives more frequently included depression on the problem list (P = .01). Recent medication use, which was stopped before conception or study participation, predicted notation of depression in the chart (P = .001).Conclusion Depression frequently is missed during pregnancy and, when identified, is underacknowledged as a problem. Women who have not recently used antidepressant medication are more likely to be missed. Better screening and acknowledgment are needed.
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Screening rates for antenatal mood disorders are low both on antenatal units and in outpatient settings.
“Screening rates for antenatal mood disorders, on antenatal units and in the outpatient setting, are low.”
From Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications (2021) · cites this paper as [69]
As many as half of patients are either not screened or misdiagnosed before delivery.
“Studies show that as many as 50% of patients are not screened or are misdiagnosed prior to delivery69,70.”
From Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications (2021) · cites this paper as [69]
Screening rates for perinatal mental health conditions are low in all settings.
“Additionally, despite recommendations to universally screen for perinatal mental health conditions [31], screening rates are low in all settings [24, 32]”
From Factors associated with postpartum depression symptoms following antepartum hospitalization (2026) · cites this paper as [32]
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- Authors
- Lyell, D. J., Chambers, A. S., Steidtmann, D., Tsai, E., Caughey, A. B., Wong, A., & Manber, R.
- Affiliations
- Lucile Packard Children's Hospital (US)
- Stanford Medicine (US)
- Oregon Health & Science University (US)
- Northwestern University (US)
- Corresponding author
- Lyell, Deirdre J.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 207
- Issue
- 6
- Pages
- 506.e1-506.e6
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2126972209
- Cited by
- 15
- References
- 25
- Citations by year
- 2026: 2 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 2
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (HS09988)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- major depressive disorder, prenatal care, maternal depression, problem list, mental health referral, antidepressant use, depression screening in pregnancy
- MeSH terms
- Adult, Antidepressive Agents, Major Depressive Disorder, Female, Humans, Mass Screening, Pregnancy, Prenatal Care, Cohort Studies, Randomized Controlled Trials as Topic
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