After having a baby, some women develop a condition called postpartum depression, or PPD, which can cause sadness, anxiety, and difficulty bonding with their newborn. Right now, most women aren't screened for PPD until about 6 to 8 weeks after giving birth, but this study wants to find out if checking earlier could help identify signs sooner. To test this, researchers will work with 428 women who deliver at an MGH hospital clinic and have no history of depression. Each woman will be randomly placed into one of two groups: one group will fill out a short depression questionnaire online at 2 to 3 weeks after delivery, while the other group will follow the usual process and complete the same questionnaire at their regular 6-week visit. The results will go to each woman's doctor, who will decide if any follow-up care is needed, just like they normally would. The study will follow each participant for 6 months after delivery to see whether earlier screening makes a difference.
Live birth, term (≥37 weeks) delivery at Massachusetts General Hospital
Access to Patient Gateway, as to receive the electronic EPDS scale
Primary obstetric provider at MGH or its affiliated clinics
No recent history of depressive disorder as determined through diagnoses or medication use*
A diagnosis code in the EHR for major depressive disorder, bipolar disorder, or psychotic disorder within the year prior to delivery
Antidepressant, antipsychotic, or bipolar medication use within the year prior to delivery
Age <18 years old
Parallel
Early PPD Screening
BehavioralEdinburgh Perinatal Depression Scale (EPDS) administered at approximately 2 weeks postpartum
Proportion of positive Edinburgh Postnatal Depression Scale (EPDS) screens at 6 weeks in the routine care group by postpartum depression (PPD) risk status
To compare rates of positive EPDS screens (EPDS \>12) at 6 weeks (in the routine care group) by PPD risk status (high vs. low)
Edinburgh Peripartum Depression Scale (EPDS) scores at 2 weeks postpartum in the early screening group by PPD risk status
To compare EPDS scores at 2 weeks postpartum by PPD risk status (high vs. low) in the early screening group. EPDS score: range 0-30; higher scores are more strongly associated with PPD
Edinburgh Postnatal Depression Scale (EPDS) score at 6 weeks in the routine screening group by PPD risk status (high vs. low).
To compare EPDS scores at 6 weeks postpartum among women at high and low risk in the standard screening group. EPDS score: range 0-30; higher scores are more strongly associated with PPD
Proportion of individuals with PPD at 6 months postpartum in the routine care group by PPD risk status
To compare the incidence of PPD (as defined by the presence of a diagnosis code for a mood or depressive disorder, a psychiatric medication prescription, or EPDS results \>12) at 6 months postpartum by PPD risk status (high vs. low) in the routine care group
Proportion of individuals with PPD at 6 months postpartum in the early screening group by PPD risk status
To compare the incidence of PPD (as defined by the presence of a diagnosis code for a mood or depressive disorder, a psychiatric medication prescription, or EPDS results \>12) at 6 months postpartum by PPD risk status (high vs. low) in the early screening group
Proportion of individuals with PPD (excluding EPDS diagnositic criteria) at 6 months postpartum in the routine care group by PPD risk status
To compare the incidence of PPD (as defined by the presence of a diagnosis code for a mood or depressive disorder, or a psychiatric medication prescription, but not an EPDS results \>12) at 6 months postpartum by PPD risk status (high vs. low) in the routine care group
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