INTRODUCTION:: Depression is a common perinatal occurrence, yet research regarding how early depression can be identified and whether it differs by pregnancy outcome (delivery/abortion) is limited. METHODS:: English- or Spanish-speaking women, aged 15–44, <24 weeks gestation seeking pregnancy testing or abortion care were enrolled in a prospective cohort study from 2014 to 2015. The Edinburgh Depression Scale (EDS) assessed depression at enrollment and 3 months later. Participants with positive depression screen (EDS ≥13) received mental health referral. Pregnancy outcomes were assessed via phone interviews and medical chart review. Women with miscarriage were excluded from this analysis. RESULTS:: Among 100 participants with complete EDS data, women averaged 26.8 (±6.3) years and 9.3 (±4.6) weeks gestation. Seventy-nine percent presented for walk-in pregnancy testing; 21% for abortion. Participants were culturally diverse: 48.0% Hispanic, 30.6% Black, non-Hispanic, 14.3% White, non-Hispanic and 7.1% multiracial. Most (66%) continued pregnancy, 44% chose abortion. At enrollment, 21% screened positive for depression, and women choosing delivery (17%) were not statistically different from women choosing abortion (29%) (P=.138). At 3-month follow-up, 18% screened positive for depression; no difference was observed between women choosing delivery (14%) compared to abortion (27%) (P=.114). The overall proportion of women with a positive screen for depression remained stable from enrollment to 3-month follow-up (P=.549), and remained stable among women choosing delivery (P=.727) and abortion (P=>.999). CONCLUSION:: Antenatal depression is common amongst women early in pregnancy, whether choosing delivery or abortion. Early screening may provide opportunities for early interventions. Future research should test early interventions.

Objective To compare the expected probability of pregnancy after hysteroscopic versus laparoscopic sterilization based on available data using decision analysis. Study design We developed an evidence-based Markov model to estimate the probability of pregnancy over 10 years after three different female sterilization procedures: hysteroscopic, laparoscopic silicone rubber band application and laparoscopic bipolar coagulation. Parameter estimates for procedure success, probability of completing follow-up testing and risk of pregnancy after different sterilization procedures were obtained from published sources. Results In the base case analysis at all points in time after the sterilization procedure, the initial and cumulative risk of pregnancy after sterilization is higher in women opting for hysteroscopic than either laparoscopic band or bipolar sterilization. The expected pregnancy rates per 1000 women at 1 year are 57, 7 and 3 for hysteroscopic sterilization, laparoscopic silicone rubber band application and laparoscopic bipolar coagulation, respectively. At 10 years, the cumulative pregnancy rates per 1000 women are 96, 24 and 30, respectively. Sensitivity analyses suggest that the three procedures would have an equivalent pregnancy risk of approximately 80 per 1000 women at 10 years if the probability of successful laparoscopic (band or bipolar) sterilization drops below 90% and successful coil placement on first hysteroscopic attempt increases to 98% or if the probability of undergoing a hysterosalpingogram increases to 100%. Conclusion Based on available data, the expected population risk of pregnancy is higher after hysteroscopic than laparoscopic sterilization. Consistent with existing contraceptive classification, future characterization of hysteroscopic sterilization should distinguish "perfect" and "typical" use failure rates. Implications Pregnancy probability at 1 year and over 10 years is expected to be higher in women having hysteroscopic as compared to laparoscopic sterilization. © 2014 Elsevier Inc.