{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T02:06:50Z","timestamp":1774490810326,"version":"3.50.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>\n            Objectives\u2003Our primary objective was to evaluate how prenatal diagnosis of a major fetal structural anomaly and resulting pregnancy outcome affected postpartum depression risk, as assessed by the Edinburgh Postnatal Depression Scale (EPDS). Secondary objectives were to review the rate of mental health follow-up and subsequent diagnosis of postpartum depression in screen-positive women.<\/jats:p><jats:p>\n            Study Design\u2003Singleton pregnancies with prenatal diagnosis of one or more major fetal structural anomalies were ascertained from prospectively maintained databases that included perinatal outcomes and subsequent EPDS responses from January 2010 to May 2018. EPDS scores of 13 or higher were considered positive and prompted referral for mental health follow-up, which was verified by medical record review. Statistical analyses were performed using Student's t-test, \u03c72, and odds ratios (ORs) with p\u2009&lt;\u20090.05 considered significant.<\/jats:p><jats:p>\n            Results\u2003A total of 1,306 women had a prenatal diagnosis of one or more major fetal structural anomalies, 896 (68%) also had a postpartum EPDS screening, and 82 (9.2%) screened positive. Positive EPDS screening was more common with anomalies of multiple organ systems (16.5 vs 7.8%, p\u2009=\u20090.002) and aneuploidy (17.1 vs 9.3%, p\u2009=\u20090.02). Pregnancies complicated by fetal death, neonatal death, and termination for anomaly were significantly more likely to screen positive than those with neonatal survival to discharge (OR, 3.1 [95% confidence interval [CI], 1.6\u20136.2], 3.0 [95% CI, 1.5\u20135.8], and 4.4 [95% CI, 2.1\u20138.9], respectively, p \u2264 0.002). Of the 35 (43%) screen-positive women who attended follow-up appointments with mental health providers, 18 (51%) were diagnosed with a depressive disorder, accounting overall for 22% of those with a positive EPDS screen.<\/jats:p><jats:p>\n            Conclusion\u2003Among women with a prenatal diagnosis of a major fetal structural anomaly, those experiencing a perinatal loss or pregnancy termination have an increased risk of positive EPDS screen result compared with who have a neonate surviving to discharge. A depressive disorder was diagnosed postpartum in 22% of these women with a positive EPDS screen. Our findings highlight the mental health needs in this vulnerable population.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1739265","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T23:46:55Z","timestamp":1636588015000},"page":"016-021","source":"Crossref","is-referenced-by-count":7,"title":["Postpartum Depression Risk following Prenatal Diagnosis of Major Fetal Structural Anomalies"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6484-9850","authenticated-orcid":false,"given":"Christina L.","family":"Herrera","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7845-6364","authenticated-orcid":false,"given":"John J.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel C.","family":"Schell","sequence":"additional","affiliation":[{"name":"Parkland Health and Hospital System, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi S.","family":"Dashe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.15585\/mmwr.mm6606a1","article-title":"Trends in postpartum depressive symptoms - 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Development of the 10-item Edinburgh Postnatal Depression Scale","volume":"150","author":"J L Cox","year":"1987","journal-title":"Br J Psychiatry"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/0165-0327(96)00008-0","article-title":"Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women","volume":"39","author":"J L Cox","year":"1996","journal-title":"J Affect Disord"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1111\/j.1600-0447.2009.01363.x","article-title":"A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women","volume":"119","author":"J Gibson","year":"2009","journal-title":"Acta Psychiatr Scand"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1136\/bmj.318.7200.1721","article-title":"Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: cohort study","volume":"318","author":"P M Hughes","year":"1999","journal-title":"BMJ"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1192\/bjp.bp.110.083105","article-title":"Previous prenatal loss as a predictor of perinatal depression and anxiety","volume":"198","author":"E R Blackmore","year":"2011","journal-title":"Br J Psychiatry"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12884-018-1666-8","article-title":"Anxiety, depression and relationship satisfaction in the pregnancy following stillbirth and after the birth of a live-born baby: a prospective study","volume":"18","author":"I K Gravensteen","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1097\/AOG.0000000000002633","article-title":"ACOG Committee Opinion No. 736: optimizing postpartum care","volume":"131","author":"ACOG","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"07","key":"ref20","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1017\/S0033291717002641","article-title":"Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women","volume":"48","author":"J Guintivano","year":"2018","journal-title":"Psychol Med"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1739265.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T23:47:17Z","timestamp":1640821637000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1739265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,10]]},"references-count":18,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2021,12,29]]},"published-print":{"date-parts":[[2022,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1739265","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,10]]}}}