Can Edinburgh Postnatal Depression Scale (EPDS) Items Predict Preterm Birth?

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  • May 3, 2020
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  • Smith, Shelby
    • Affiliation: School of Nursing
Abstract
  • Introduction: Preterm birth (PTB) is a pressing health problem worldwide. Women who experience anxious or depressive symptoms during pregnancy are at increased risk for PTB. Clinical research and healthcare providers frequently assess mood symptom severity as the sum-scores of symptoms represented using self-report scales. However, the sum-score method does not represent possible heterogenous symptoms and differential outcomes. In this study, we sought to assess which individual EPDS components are most strongly associated with PTB. Methods: Retrospective cohort study of women at high risk for PTB who received prenatal care at a single tertiary care facility, delivered a singleton, non-anomalous fetus from 4/2014-7/2019, and completed ≥1 EPDS assessment at <24 weeks’ gestation. Logistic regression was used to test whether individual scores for each of the 10 EPDS items had differential association between gestational age at birth. Results: 1,418 women were included; 250 (17.6%) delivered < 37 weeks’ gestation. Individual EPDS items and the total EPDS score were both higher among women who eventually delivered preterm. In logistic regression models, each additional point on the total EPDS score was associated with a small (3%) increase in the odds of PTB while points on questions 2 (addressing anhedonia), 3 and 5 (both addressing anxiety) were associated with a 29%, 22%, and 21% increased odds of PTB, respectively. Conclusion: Responses to individual items of the EPDS in early pregnancy, specifically within the anhedonia and anxiety domains, are associated with PTB. Future risk elucidation may improved screening for targeted psychosocial interventions to reduce prematurity.
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  • Bachelor of Science
Graduation year
  • 2020
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  • English

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