Screening for Depression in Pregnancy

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The United States Preventative Services Task Force recommended depression screening for pregnant and postpartum women in the Journal of the American Medical Association last week. The task force is an independent, volunteer panel of experts in preventative health who advise the government and public health community.

The study reviewed the existing medical literature on the benefits and risks of depression screening in pregnant and postpartum women concluding that, “evidence suggested that programs to screen pregnant and postpartum women, with or without additional treatment-related supports, reduced the prevalence of depression and increased remission or treatment response.”

This is a significant finding given the current debate in the medical community about whether screening for perinatal mood and anxiety disorders actually reduces their prevalence. The study looked only at screening programs that utilized the Edinburgh Postnatal Depression Scale, a 10-question screening tool that has been shown to be effective in identifying perinatal depression, and primarily focused on programs that did include treatment protocols or counseling with “specially trained clinicians.”

The only risk identified by the task force was the potential that use of antidepressant medication during pregnancy can present a small risk to a developing embryo or fetus, but concluded that “the absolute risk of harm appeared to be small,” and that cognitive behavioral therapy was an effective treatment alternative.

Not only do the panel’s recommendations carry tremendous weight in the medical and health policy communities, but the panel gave the recommendation for perinatal depression screening their second to highest rating (a “B”), which means that screening must be covered under the Affordable Care Act.