Publication year
2010
Citation Title
Effects of deployment on depression screening scores in pregnancy at an Army military treatment facility.
Journal Name
Obstetrics & Gynecology
Journal Volume
116
Issue Number
3
Page Numbers
679
DOI
10.1097/aog.0b013e3181eb6c84
Summary
Surveys were completed by 3,956 female Active Duty Soldiers or pregnant spouses of Soldiers at an initial obstetric visit. Participants completed surveys at 28-32 weeks gestation and again at 6-8 weeks postpartum. Results were used to examine the relationship between positive depression screening and spouse deployment status. The risk of a positive depression screen more than doubled in those whose spouse was deployed during the 28-32 week gestation period compared to those with a spouse not planning to deploy.
Key Findings
At the initial obstetric visit, the prevalence of an elevated depression score was 14% for those with a spouse returning from deployment, 13% for those with a spouse currently deployed, 7% for those preparing for deployment, and 4% for no deployment planned.
At the 28-32 week gestational visit, the prevalence of an elevated depression score was 21% for those with a spouse returning from deployment, 14% for those preparing to deploy, 10% for those with a spouse who was currently deployed, and 10% for those with no deployment planned.
At the postpartum visit, the prevalence of an elevated depression score was 16% for those with a spouse who was currently deployed, 12% for those preparing to deploy, 8% for those with a spouse returning from deployment, and 8% for no deployment planned.
Implications for Program Leaders
Offer pregnant women with spouses in the process of deployment classes on stress and depression management, positive coping strategies during deployment, and parenting
Collaborate with military medical facilities to reach out to pregnant spouses of Service members in order to review family programs that may be useful to them
Offer peer-led support groups for pregnant women
Implications for Policy Makers
Recommend depression screening at multiple time points during and after pregnancy for women at military medical facilities
Continue services for pregnant partners of Service members in the process of deployment
Encourage the development and continuation of programs that can promote resilience in Service members and their partners
Methods
Participants included pregnant Active Duty Soldiers and pregnant partners of Service members who presented at Madigan Army Medical Center (2007-2009) and who completed depression screenings at their obstetric visits.
Participants reported on their depression and their spouse’s deployment status.
Statistical analyses compared depression scores across the three time periods and across deployment group.
Participants
The sample consisted of 3,956 female participants.
Fifty-two percent of the surveys were collected at the initial visit, 14% at the 28-32 week visit, and 34% at the postpartum visit.
No demographic data was presented.
Limitations
The analyses did not account for some women answering multiple questionnaires.
The study was retrospective which may introduce recall bias in the participants' responses.
Since no demographic data were presented, it is unclear if factors such as participation rate could have been influenced by deployment status or another variable.
Avenues for Future Research
Compare depression scores of pregnant Active Duty Soldiers to civilian expectant mothers
Use clinical interviews and non-self-report measures to strengthen these findings
Examine the effectiveness of support programs for pregnant women
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
OBJECTIVE: To estimate the relationship of positive screening for depression during and after pregnancy with deployment status of the spouse. METHODS: We conducted a retrospective cohort study by reviewing a departmental database of women who completed the Edinburgh Postpartum Depression Scale during pregnancy from 2007 to 2009. Per departmental protocol, screening is offered at the initial obstetric visit, at 28 weeks of gestation, and at 6 weeks postpartum. A score of 14 or higher was considered high risk for having depression, and referral for additional evaluation was recommended. Included in our survey was an additional question that asked if the patient's spouse was currently deployed, returning from deployment, preparing to deploy, or if no deployment was planned. All data were entered into an electronic database and statistical analysis performed comparing Edinburgh Postpartum Depression Scale scores at each time period and deployment status. RESULTS: A total of 3,956 surveys were complete and available for analysis. The risk of a positive screen was more than doubled compared with the control group (no deployment planned) if the spouse was deployed during the 28–32 week visit (4.3% compared with 13.1%, P=.012) or the postpartum period (8.1% compared with 16.2%, P=.006). CONCLUSION: Deployment status has a measurable effect on the prevalence of elevated depression screening scores during pregnancy and in the postpartum period. These findings suggest that more intense monitoring, assessment, and treatment may be warranted for this at-risk population.
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