Background

Universal screening for postpartum depression is crucial for early detection, interventions and support. The aim of this study was to describe the proportion of, and explore risk factors for, women not being offered screening, as well as for declining an offer or not being screened due to any other unknown reason.

Methods

Socioeconomic, obstetrical and neonatal data, extracted from the Swedish Pregnancy Registry, for 9,959 pregnancies recorded for the Östergötland county between 2016 and 2018 were linked to Edinburgh Postnatal Depression Scale (EPDS) screening results at 6–8 weeks postpartum, extracted from medical records. Risk factors were assessed using logistic regression models and with a nomogram for easy visualization.

Results

In total, there were no recorded offers of EPDS screening in the medical records for 30.0% of women at the postpartum follow-up. Women born outside of Sweden and women reporting poor self-rated health were at increased risk of not being offered screening for postpartum depression.

Limitations

There is a possibility that women were offered screening or were screened, but this was incorrectly or never recorded in medical records.

Conclusions

The majority of women were offered screening for postpartum depression, but there is room for improvement in order to achieve universal screening. Awareness among healthcare providers of the risk factors for not screening might increase adherence to guidelines for universal screening. Overcoming barriers for screening and raising the topic of mental-health issues for postpartum women should be prioritized.

中文翻译：

---

在筛查产后抑郁症时我们会错过谁？在瑞典地区进行的一项基于人群的研究

背景

普遍筛查产后抑郁症对于早期发现、干预和支持至关重要。本研究的目的是描述女性未接受筛查，以及因任何其他未知原因拒绝接受筛查或未接受筛查的比例，并探讨其风险因素。

方法

从瑞典怀孕登记处提取的社会经济、产科和新生儿数据，对于 2016 年至 2018 年期间在东约特兰县记录的 9,959 次怀孕，与产后 6-8 周的爱丁堡产后抑郁量表 (EPDS) 筛查结果相关，从医疗记录中提取。使用逻辑回归模型和列线图评估风险因素，以便于可视化。

结果

总的来说，在产后随访中，30.0% 的女性的医疗记录中没有记录提供 EPDS 筛查。在瑞典以外出生的女性和报告自评健康状况不佳的女性在不接受产后抑郁症筛查的风险增加。

限制

有可能为女性提供筛查或接受筛查，但这在医疗记录中记录不正确或从未记录。

结论

大多数妇女接受了产后抑郁症的筛查，但为了实现普遍筛查，还有改进的余地。医疗保健提供者对不筛查的风险因素的认识可能会增加对普遍筛查指南的依从性。应优先考虑克服筛查障碍和提出产后妇女心理健康问题的话题。