Smoking status: A tacit screen for postpartum depression in primary care settings
| Autor: | Edmond D. Shenassa, Gabriela A. Barber |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Postpartum depression
medicine.medical_specialty Routine screening Primary Health Care Obstetrics business.industry Postpartum Period Smoking Prenatal Care Primary care medicine.disease Depression Postpartum Psychiatry and Mental health Clinical Psychology Pregnancy Risk Factors Clinical diagnosis medicine Humans Female Smoking status business Psychosocial Limited resources Perinatal Depression |
| Zdroj: | Journal of Affective Disorders. 295:1243-1250 |
| ISSN: | 0165-0327 |
| DOI: | 10.1016/j.jad.2021.09.033 |
| Popis: | Background Universal screening for postpartum depression (PPD) remains an unachieved national priority. A tacit screen that requires no additional resources for administration can help to achieve this priority. We examine the predictive utility of using smoking as a tacit screen for PDD. We first establish smoking is a valid proxy for more prominent psychosocial determinants of PPD and is a predictor for PPD. Methods We analyzed PRAMS data (2012-2015; N=134,435). Time of smoking was categorized as nonsmoker, during the prenatal period, the postpartum, or continuously; PPD was assessed using two PHQ-2 style questions. Results Compared to nonsmokers, women who smoked only during the prenatal period (OR: 1.41; 95% CI: 1.06 – 1.86), only during the postpartum (OR: 1.33; 95% CI: 1.18 – 1.49), and continuously throughout both periods (OR: 1.54; 95% CI: 1.41 – 1.69) were more likely to experience PPD. Smoking assessed at a prenatal visit (SN: 0.90, SP: 0.21), postpartum visit (SN: 0.86, SP: 0.25), or assessed at both visits (SN: 0.90, SP: 0.19) performed relatively well as a tacit screen for PPD, performing better among unmarried women (SN: 0.75 – 0.81; SP: 0.29 – 0.36). Limitations In this study, the criterion of positivity used was PRAMS’ adapted version of the PHQ-2. This tacit screen may perform differently relative to a clinical diagnosis. Conclusions Time of smoking predicts risk of PPD and can be used to tacitly screen for PPD with reasonable accuracy without requiring any additional time in settings with limited resources for routine screening of PPD. |
| Databáze: | OpenAIRE |
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