Danielle L Cooke, Jack Dempsey, Eleanore M Hall, Hisham Nsier, Michael Zaretsky, Jessalyn Kelleher, Allison G Dempsey
The Edinburgh Postnatal Depression Scale (EPDS) and its three-item subsection (EPDS-3A) are screening tools for perinatal depression and anxiety, respectively. There is limited research on their use in fetal care centers despite high rates of perinatal mood and anxiety disorders. This study aims to evaluate the short-term test-retest reliability of the EPDS and assess the utility of the EPDS-3A. Screening data collected during a clinical quality improvement initiative at a fetal care clinic was evaluated, including EPDS, EPDS-3A, and Generalized Anxiety Disorder-7 (GAD-7) scores. Rates of positive screens and sensitivity/specificity analyses were calculated to compare anxiety screeners. Initially the EPDS and GAD-7 were administered at every visit (visits ranged from 1 to 30 d). The EPDS-3A had good sensitivity and specificity compared against the GAD-7. When comparing either a positive score on the EPDS and/or a positive score on the EPDS-3A to the GAD-7, sensitivity increased and specificity decreased. During the study, the GAD-7 was discontinued due to redundancy, and screening cadence was reduced. The EPDS with the EPDS-3A has excellent identification of psychological distress in a fetal care center. Screening scores appear to be reliable up to one month, and more frequent administration may be unnecessary.