Depressive Symptoms among Pregnant Women Screened in Obstetrics Settings
Open accessAbstract
OBJECTIVES: This study aimed to describe the prevalence of depressive symptomatology during pregnancy when seen in obstetric settings, the extent of treatment in this population, and specific risk factors associated with mood symptoms in pregnancy. METHODS: A total of 3472 pregnant women age 18 and older were screened while waiting for their prenatal care visits in 10 obstetrics clinics using a brief (10 minute) screening questionnaire. This screen measured demographics, tobacco and alcohol (TWEAK problem alcohol use screening measure), and depression measures, including the Center for Epidemiological Studies-Depression scale (CES-D), use of antidepressant medications, past history of depression, and current treatment (i.e., medications, psychotherapy, or counseling) for depression. RESULTS: Of women screened, 20% (n = 689) scored above the cutoff score on the CES-D, and only 13.8% of those women reported receiving any formal treatment for depression. Past history of depression, poorer overall health, greater alcohol use consequences, smoking, being unmarried, unemployment, and lower educational attainment were significantly associated with symptoms of depression during pregnancy. CONCLUSIONS: These data show that a substantial number of pregnant women screened in obstetrics settings have significant symptoms of depression, and most of them are not being monitored in treatment during this vulnerable time. This information may be used to justify and streamline systematic screening for depression in clinical encounters with pregnant women as a first step in determining which women may require further treatment for their mood symptoms. As elevations in depressive symptomatology have been associated with adverse maternal and infant outcomes, further study of the impact of psychiatric treatment in gravid women is essential.
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Only about 12% to 25% of depressed women receive treatment during the postpartum period.
“however only about 12% to 25% of depressed women receive treatment during the postpartum period (Goodman and Tyer-Viola 2010; Horowitz and Cousins 2006; Marcus et al. 2003).”
From Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial (2015) · cites this paper as Marcus et al. 2003
The Descriptions of depression section reports treatment rates of 13.8% and 24.6% for groups of pregnant women, which are approximately within the claimed range. The study screened women during pregnancy, not the postpartum period, so it does not establish postpartum treatment rates. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEven if depressed women are identified, few are treated.
“Moreover, even if depressed women are identified, few are treated [16].”
From The mastery lifestyle intervention to reduce biopsychosocial risks for pregnant Latinas and African Americans and their infants: protocol for a randomized controlled trial (2022) · cites this paper as [16]
The Abstract and “Descriptions of depression” report that only 13.8% of pregnant women who screened positive for elevated depressive symptoms were receiving formal treatment. This supports low treatment rates in the screened group, but the paper does not establish that the women had a depression diagnosis or that they remained untreated after being identified by a clinician. The claim also omits the study’s pregnancy setting. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn the absence of systematic screening in routine prenatal care, affected women are often not identified.
“In the absence of systematic screening in routine prenatal care, affected women are often not identified (35–38).”
From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [37]
The Discussion reports that routine depression monitoring did not occur at the study sites and that 86% of women with significant symptoms received no treatment. It says these women were *likely* not being monitored, but explicitly notes that this was not directly assessed; the study did not establish how often they went unidentified. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L.
- Affiliations
- University of Michigan (US)
- Venue
- Journal of Women's Health
- Publisher
- SAGE Publications
- Published
- 2003-05
- Volume
- 12
- Issue
- 4
- Pages
- 373-380
- ISSN
- 1059-7115 (ISSN-L)
- 1540-9996
- 1931-843X
- OpenAlex
- W1992853570
- Cited by
- 742
- References
- 57
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 19 · 2023: 20 · 2022: 34 · 2021: 31 · 2020: 32 · 2019: 34 · 2018: 46 · 2017: 41 · 2016: 33 · 2015: 44 · 2014: 60 · 2013: 38 · 2012: 46
- FWCI
- 20.32
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Journal of Women s Health (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- 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 › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- antenatal depression, depressive symptoms, prenatal screening, antidepressant use, treatment gap, risk factors, alcohol consumption, smoking, marital status, educational attainment, unemployment, CES-D
- MeSH terms
- Adult, Attitude to Health, Depression, Female, Humans, Mass Screening, Middle Aged, Pregnancy, Pregnancy Complications, Prenatal Care, Surveys and Questionnaires, Risk Factors, Self Concept, Socioeconomic Factors, United States, Logistic Models, Women's Health, Substance-Related Disorders
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