Postpartum Depression Screening in Pediatric Primary Care Clinics and Infant Receipt of Preventive or Acute Care.

IF 3 3区 医学 Q1 PEDIATRICS Academic Pediatrics Pub Date : 2024-08-05 DOI:10.1016/j.acap.2024.08.001
Danielle P Tyson, Leah Vance Utset, Rose Y Hardy, Mattina A Davenport, Kierra S Barnett, Deena J Chisolm, Laura J Chavez
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Abstract

Objective: To evaluate the association between postpartum depression (PPD) screening results in pediatric primary care and subsequent infant preventive and acute care utilization.

Methods: This was a retrospective cohort analysis of 5,341 infants born in 2021 whose mothers were screened for PPD at a well-child visit during the first 6 months. Logistic regression was used to examine that association between a positive PPD screen and 1) adherence to the 12-month well-child visit, and 2) any acute care visits (urgent care or emergency department visits) from 6-15 months. The association between PPD screen and number of acute care visits was examined with negative binomial logistic regression.

Results: The incidence of positive PPD screens was 15.6% in the first 6 months. There was no significant difference in 12-month well-child visit adherence based on PPD screening (adjusted odds ratio (aOR): 0.91; 95% confidence interval (CI): 0.77 to 1.06; p-value: 0.206). The odds of having any acute care visit were higher among infants whose mothers screened positive for PPD (aOR: 1.2; 95% CI: 1.0 to 1.3; p-value: 0.009). There was a significant difference in the incidence rate of acute care visits based on PPD screening results (incidence rate ratio: 1.1; 95% CI: 1.0 to 1.2; p-value: 0.005).

Conclusions: Screening positive for PPD was associated with subsequent acute care utilization but not 12-month preventive care. Primary care providers may need to proactively follow-up after acute care visits to ensure both infant health and maternal needs are met, connecting mothers to resources as needed.

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儿科初级保健诊所的产后抑郁症筛查与婴儿接受预防性或急性护理的关系。
目的评估儿科初级保健中产后抑郁症(PPD)筛查结果与随后婴儿预防和急症护理使用之间的关联:这是一项回顾性队列分析,研究对象是 2021 年出生的 5341 名婴儿,这些婴儿的母亲在头 6 个月的儿童健康检查中接受了 PPD 筛查。采用逻辑回归法研究了 PPD 筛查阳性与 1) 12 个月儿童健康检查的坚持率,以及 2) 6-15 个月期间任何急诊就诊(紧急护理或急诊就诊)之间的关联。PPD 筛查与急诊就诊次数之间的关系采用负二项逻辑回归法进行检验:结果:PPD筛查阳性率在前6个月为15.6%。根据 PPD 筛查结果,12 个月的儿童保健就诊率没有明显差异(调整后的几率比 (aOR):0.91;95% 置信区间 (CI):0.77 至 1.06;P 值:0.206)。母亲 PPD 筛查呈阳性的婴儿接受任何急症护理的几率更高(aOR:1.2;95% CI:1.0 至 1.3;p 值:0.009)。根据 PPD 筛查结果,急诊就诊率存在明显差异(发病率比:1.1;95% CI:1.0 至 1.2;P 值:0.005):结论:PPD筛查结果呈阳性与随后的急症护理使用率有关,但与12个月的预防性护理无关。初级医疗服务提供者可能需要在急诊就诊后主动跟进,以确保婴儿健康和孕产妇需求得到满足,并根据需要将母亲与资源联系起来。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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