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The CES-D: Measuring Effectiveness in Screening for Prenatal Depression

Blau, Whitney and Breedlove, Ginger
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Abstract
Prenatal depression, though less famous than postpartum depression, has serious implications for maternal and fetal outcomes. Estimates suggest that depression affects 7-13% of all adult women in the United States, while, current research estimates that 8-51% of women have experienced depression or depressive symptoms throughout their pregnancy. Depression in pregnancy can lead to complications, decreased compliance with medical advice, and interrupted maternal-fetal bonding. This sub-study, using data from a current, descriptive longitudinal study, seeks to increase understanding about the occurrence of prenatal depression and related maternal behaviors. Data were collected from the population of interest, comprised of 66 publicly or privately insured pregnant women who reside in the greater metropolitan area of a Midwest city. A convenience sample of women, enrolled prior to 21 weeks gestation, was recruited at 4 maternity care offices with assistance of nurse midwives. This sub-study compares prenatal depression results from the Centers for Epidemiologic Studies Depression Scale (CES-D), administered at enrollment and 34 weeks gestation, with results from similar studies conducted in the United States during the last 5 years. The CES-D is a 20 item scale designed to detect depressive symptoms in the general population. A score of 16 or greater is indicative of risk for depression. Results indicated that the percentage of prevalence for risk of prenatal depression, (CES-D score of 16 or greater) was 30.9% at enrollment, and 20.5% at Time 2 (34 weeks gestation) compared with selected studies that indicate prevalence at 20-44%. Participants reported an average age of 25 years, were primarily Caucasian (68%), married (59%), and 25% of participants had attained at least a baccalaureate education, indicating that this study evaluated prenatal depression in an understudied population. Enhanced knowledge about the prevalence of prenatal depression will facilitate discussion and further research in this area. Provider awareness of the incidence and significance of prenatal depression can improve outcomes by enhancing patient disclosure, facilitating appropriate diagnosis, and initiating early treatment.
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2009-07-23
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