Investing in maternal and infant mental health - Screening for postpartum depression by preventive child health care
Due to the COVID-19 crisis the PhD defence Angarath van der Zee-van den Berg will take place online (until further notice).
The PhD defence can be followed by a live stream.
Angarath van der Zee-van den Berg is a PhD student in the research group Health Technology & Services Research. Her supervisors are dr. M.M. Boere-Boonekamp from the Faculty of Behavioural, Management and Social Sciences (BMS) and prof.dr. S.A. Reijneveld, University of Groningen.
One in 10 women will experience a depression after childbirth, also known as postpartum depression (PPD). In her PhD study, Angarath van der Zee investigated whether the use of the Edinburgh Postnatal Depression Scale (EPDS) - a screening questionnaire aimed at identifying PPD - by preventive child health care helps to improve health outcomes for mother and child. She also examined the impact of PPD on health care utilization of mother and child, and maternal participation in work. In addition, she investigated whether the EPDS can also be used to identify anxiety symptoms after childbirth, and the similarities and differences between the risk factors for depression and anxiety after childbirth.
Screening by preventive child health care 1, 3 and 6 months after delivery results in better outcomes for mothers. Mothers have less depressive symptoms, more confidence in their own parenting skills, less anxiety symptoms and a better general mental wellbeing. Van der Zee found no measurable effect of screening for PPD on the socioemotional development of the children at the age of 1 year. This requires further research.
Van der Zee found that adequate detection of anxiety symptoms is not ensured by using the EPDS. As anxiety symptoms occur at least as frequent as depression symptoms in the postpartum period, other ways to detect anxiety have to be explored. The factors found associated with higher risk for either depression or anxiety or both can be used to support detection.
A limited number of mothers with PPD appear to receive care for their PPD symptoms. In addition, mothers with PPD make more use of general care, both for themselves and for their child. Also, mothers with PPD are significantly more absent from work. Screening for PPD therefore helps mothers and reduces the social costs of PPD, in terms of work and care use.
This calls for a national implementation of this screening, and optimization of the pathway of care after screening. With limited investments, we can contribute greatly to reducing PPD and thus increase the wellbeing of mothers and their children.