Maternal Depression Screening During Prenatal and Postpartum Care at a Navy and Marine Corps Military Treatment Facility

Authors
Spooner, S. Rastle, M. Elmore, K.
Publication year
2012
Citation Title
Maternal depression screening during prenatal and postpartum care at a Navy and Marine Corps military treatment facility.
Journal Name
Military Medicine
Journal Volume
177
Issue Number
10
Page Numbers
1208-1211
DOI
10.7205/milmed-d-12-00159
Summary
Survey data from wives of male Service members who were receiving obstetric care at a Navy and Marine Corps military treatment facility were used to evaluate rates of perinatal depression and assess the impact of deployment as a risk factor. Results suggested relatively low rates of perinatal depression, although rates of depression did vary according to husbands deployment status.
Key Findings
Five percent of surveys indicated high risk for depression at each time point (i.e., initial obstetric visit, 28- to 32-gestational weeks, and six weeks postpartum).
At the initial obstetric visit, there was a significantly higher proportion of depression among women whose husbands were deployed than those whose husbands were not deployed.
At six-weeks postpartum, there were a significantly higher rate of depression among women whose husbands were deployed or preparing to deploy compared to those whose husbands were not deployed.
There were no differences in the proportion of positive depression screens according to deployment status at the 28- to 32-gestational week appointment.
Implications for Program Leaders
Offer suppor groups to pregnant women whose husbands are deployed or are preparing to deploy in order to reduce the risk of depression
Offer childcare for military mothers struggling with postpartum depression
Publish information to military families regarding the symptoms of postpartum depression and resources that can help families cope

Implications for Policy Makers
Recommend that military hospitals routinely screen for depression among pregnant mothers
Promote the development and continuation of maternal support programs throughout the deployment cycle
Recommend the development of educational campaigns (e.g., information on websites, posters in clinics) regarding depression related to pregnancy.
Methods
Retrospective medical record data were used for the current study; women had to have completed a depression screen and reported their husbands deployment status during an obstetric visit to be included.
Data were collected between October 1, 2007 and June 30, 2009.
Records were from the Naval Hospital at Camp Pendleton, which provides services for mostly Marine and Navy families.
Participants
A total of 3,882 depression screens were included in the analysis; 1,724 were completed at the initial visit, 1,058 were completed at the 28- to 32-gestational week visit, and 1,100 were completed at the six-week postpartum visit.
Only medical records of spouses of an Active Duty Service member were included in the study.
No additional demographic data is provided.
Limitations
The analyses were limited to a single measure of depression and a single question regarding husbands deployment status, which may influence the results.
Other factors that may have influenced results (e.g., demographics, medical history, etc.) were not assessed.
The sample was from a single military hospital that had supportive programs for women in the prenatal and postpartum periods, likely limiting the ability to generalize the findings.
Avenues for Future Research
Systematically evaluate the effectiveness of maternal support programs to assess their effectiveness in reducing perinatal depression
Utilize focus groups or individual interviews to more deeply explore the mental health challenges of military mothers during pregnancy
Assess other factors related to Service member deployment (e.g., length, frequency) to consider their impact on their wives levels of depression
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Maternal depression in the prenatal and postpartum periods is an important concern for women, infants, and families. Military family life may create some unique stressors, including operational deployment of an active duty husband, which increase perinatal depression challenges for women. This study examined depression screening scores, based on a modified Edinburgh Postpartum Depression Scale, among women receiving obstetric care at a military hospital serving a Navy and Marine Corps community. Among 3,882 surveys collected between 2007 and 2009 from women at various points in their prenatal or postpartum care, the proportion with scores indicative of high risk for clinical depression was relatively low at 4.6%. However, scores were significantly higher at the initial obstetric visit among women who reported their husband as currently deployed, and scores were significantly higher at the postpartum visit among women who reported their husband as currently deployed or planning to deploy. These results underscore the importance of evaluating all aspects of the military family life experience when providing perinatal care to women in military families.
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