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Int J Gynaecol Obstet. 2014 Jul;126(1):74-7. doi: 10.1016/j.ijgo.2014.01.011. Epub 2014 Apr 2.

Community-based prenatal screening for postpartum depression in a South African township.

Author information

  • 1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA. Electronic address: khung@bidmc.harvard.edu.
  • 2Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
  • 3Philani Maternal Child Health and Nutrition Project, Cape Town, South Africa.
  • 4Health Systems Research Unit, Medical Research Council of South Africa, Tygerberg, South Africa.
  • 5Health Section, United Nations Children's Fund, NY, USA.
  • 6Center for Global Health, Massachusetts General Hospital, Boston, USA; Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, USA; Harvard Medical School, Boston, USA; Mbarara University of Science and Technology, Mbarara, Uganda.

Abstract

OBJECTIVE:

To assess the feasibility of using community health workers to administer short or ultra-short screening instruments during routine community-based prenatal outreach for detecting probable depression at 12 weeks postpartum.

METHODS:

During pregnancy and at 12 weeks postpartum, the 10-item Edinburgh Postnatal Depression Scale (EPDS-10) was administered to 249 Xhosa-speaking black African women living in Khayelitsha, South Africa. We compared the operating characteristics of the prenatal EPDS-10, as well as 4 short and ultra-short subscales, with the criterion standard of probable postpartum depression.

RESULTS:

Seventy-nine (31.7%) women were assessed as having probable postpartum depression. A prenatal EPDS-10 score of 13 or higher had 0.67 sensitivity and 0.67 specificity for detecting probable postpartum depression. Briefer subscales performed similarly.

CONCLUSION:

Community health workers successfully conducted community-based screening for depression in a resource-limited setting using short or ultra-short screening instruments. However, overall feasibility was limited because prenatal screening failed to accurately predict probable depression during the postpartum period.

KEYWORDS:

Postpartum depression; Screening; Sub-Saharan Africa

PMID:
24786139
PMCID:
PMC4053501
DOI:
10.1016/j.ijgo.2014.01.011
[PubMed - indexed for MEDLINE]
Free PMC Article
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