UC Irvine

Antenatal depression is a non-psychotic depressive disorder that can occur during pregnancy and advance into the postpartum period if not addressed (Verreault et al., 2014). This type of depression can lead to poor maternal and fetal outcomes including and not limited to: gestational hypertension, prematurity, low birth weight, preeclampsia, and mental health problems (Dadi et al., 2020; Sidebottom et al., 2012). Antenatal depression is not routinely screened as evidenced by the clinical guidelines outlined by The American College of Obstetricians-Gynecologists (ACOG) (2018) who recommends screening for depression once perinatally with an emphasis on the postpartum period. In addition, ACOG (2018) offers several different depression screening tools to choose from when screening perinatally including but not limited to: the Edingburgh Depression Scale (EDS) and the Patient Health Questionnaire-9 (PHQ-9). These two depression screening tools are proven to have strong validity and reliability (Bergnik et al., 2011; Brancaglion et al., 2013; Flynn et al., 2011; Heyningen et al., 2018; Kozinsky & Dudas, 2015; Levis et al., 2020; Stewart et al., 2013; Sidebottom et al., 2012; Wang et al., 2021; Woldentensay et al. 2018; Zhong et al., 2014). Inadequate recognition of antenatal depression could be largely due to the fact pregnant women are not routinely screened throughout pregnancy in accordance with the 2018 national clinical guidelines. The purpose of this quality improvement project is to increase the frequency of screening for antenatal depression, determine if both the EDS and PHQ-9 capture antenatal depression similarly across the three trimesters of pregnancy, and to determine how many pregnant women screen positive with the utilization of these two depression screening tools. Pregnant women who were 18 years or older were screened for antenatal depression in two different trimesters (i.e., first and second or second and third trimester) using both the EDS and PHQ-9 over an 11-week timeframe. Patients who screened positive on one or both depression screening tools were given an immediate in-person interview by the attending OB/GYN; if deemed necessary these patients were referred to a mental health provider. Data was collected via the electronic medical record and input into an excel spreadsheet and percentages were utilized for the data analysis. Findings of this project determined that 1) more pregnant patients screened positive in the second and third trimesters of pregnancy, 2) the EDS captured more positive scores versus the PHQ-9, 3) increased screening for antenatal depression across the three trimesters of pregnancy resulted in more detection of antenatal depression.