Assessing Depressing before Postpartum
Denise M. Massey RNC-OB
Nur/518 Analysis of Research Reports
March 11, 2013
Jane Cash RN, PhD

Depression is very common in modern troubling times. During pregnancy women are more vulnerable to depression because of the hormonal changes their bodies are undergoing. It is important for health care providers to assess signs and symptoms of depression during routine prenatal visits because there is a strong correlation between antepartum depression and postpartum depression. Researchers conducted a systematic review of many research articles trying to discover the risk factors commonly found in women who suffered from depression during their pregnancy. The most common risk factors for pregnancy-related depression were life stress in the form of daily hassles, living with a partner exhibiting violence either physically or emotionally, and lacking social support. “Life stress, lack of social support and domestic violence continued to demonstrate a significant association” (Lancaster, Gold, Flynn, Yoo, Marcus, & Davis, 2010, p. 5) to antepartum depression. Doctors, however, are lacking in the skill to treat depression during pregnancy. “Less than half of obstetricians report that residency prepared them to diagnose depression” (Lancaster, et al., 2010, p. 5). It is important for doctors to understand the risk factors for women that suffer from depression so they can get help. Those with depressive symptoms during pregnancy are prone to suffering from postpartum depression. This is a difficult thing to suffer from because the baby is affected by the mother’s depression. Lack of bonding and difficulty adjusting to motherhood are common for women who suffer from depression. It is the provider’s responsibility to adequately screen women for depression and give them the help they need if they are suffering from this psychological disorder. According to Bennett, Einarson, Taddio, Koren, and Einarson (2004), the “rates of depression are higher in second and third trimesters” (p. 698). This is the time when women are going more frequently to their provider for prenatal visits. Depression should be routinely screened using scales to measure how the women are feeling during their pregnancy. Because of the high degree of impairment in depressive disorders, health care providers need to treat the mental diseases as seriously as diabetes or hypertension. “Depression has been identified as a leading cause of disability-adjusted life years (ie, the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability) for women globally” (Bennett, Einarson, Taddio, Koren, Einarson, 2004, p. 698).
A systematic review is conducted when researchers analyze the best evidence about a particular subject then combine and explore all the current relevant research. Systematic reviews must have sound inclusion and exclusion data, an explicit searching strategy, systematic coding and inclusion of studies, and must try to include meta-analyses (The Campbell Collaboration, 2013). “The researchers in the study by Lancaster, et al. used Boolean searching strategies to identify articles, dissertations, theses, or abstracts that contained the words depression, pregnancy, and screening. The dates searched started in 1980 and ended in 2008. The article used the most current studies from the last five years and older references that helped them substantiate their research problem. The researchers search vast amounts of databases like PubMed, CINAHL, pschINFO, proQuest, SCOPOS, Sociological abstracts, ISI Proceedings, 3 medical guidelines, 2 ACOG Committee opinions, and the bibliographies of a large systematic review. The fact that they included grey literature shows how thorough the researchers were in exploring depression.
Separate reviewers were used to reach consensus of which articles to include in the systematic review. The