Medical University of South Carolina, Charleston, SC.
Adv Neonatal Care. 2022 Jun 1;22(3):E102-E110. doi: 10.1097/ANC.0000000000000971. Epub 2021 Dec 28.
Postpartum depression (PPD) is a common mental health condition that affects approximately 13% of postpartum women in the United States. However, the prevalence in the neonatal intensive care unit (NICU) has been shown to be higher. Routine screening for maternal PPD is recommended at infant primary care well-child visits up to 6 months of age. The absence of a routine PPD screening program in a level IV NICU created a large gap in screening in an at-risk population.
To develop and implement a screening program in the NICU to increase the identification of maternal PPD symptoms and to develop both a referral algorithm for NICU staff to follow and a referral resource packet to be given to mothers with positive PPD screenings.
Mothers with infants in the NICU were screened for PPD using the Edinburgh Postnatal Depression Scale (EPDS). Bedside nurses administered the screening tool and used a referral algorithm to determine appropriate follow-up. EPDS scores of 10 or more were considered positive and indicated a need for referral.
The overall EPDS screening compliance was 66% with a positive rate of 26%. Nurses followed the referral algorithm appropriately 100% of the time. It was confirmed that 93% of the mothers with positive EPDS screenings sought help from a mental health provider.
Routine maternal PPD screening should be implemented in all NICU settings. Postpartum mental health issues should not be the sole responsibility of obstetricians, mental health providers, or maternal primary care providers.
产后抑郁症（PPD）是一种常见的心理健康问题，影响了美国约 13%的产后女性。然而，在新生儿重症监护病房（NICU）中的患病率较高。建议在婴儿初级保健儿童保健就诊时（直至 6 个月大）对产妇 PPD 进行常规筛查。由于在四级 NICU 中没有常规 PPD 筛查计划，因此在高危人群中筛查存在很大差距。
在 NICU 中开发和实施筛查计划，以增加对产妇 PPD 症状的识别，并为 NICU 工作人员制定一个转介算法，以跟进和制定一个转介资源包，以便将 PPD 筛查呈阳性的母亲转介。
使用爱丁堡产后抑郁量表（EPDS）对 NICU 中的母亲进行 PPD 筛查。床边护士进行筛查工具的管理，并使用转介算法来确定适当的随访。EPDS 评分为 10 分或更高者被认为呈阳性，并表示需要转介。
总体 EPDS 筛查合格率为 66%，阳性率为 26%。护士 100%地遵循了转介算法。可以确认，93%的 EPDS 筛查呈阳性的母亲向心理健康提供者寻求帮助。
所有 NICU 环境都应实施常规产妇 PPD 筛查。产后心理健康问题不应仅由妇产科医生、心理健康提供者或产妇初级保健提供者负责。
