DR. MANNY: Why I support new guidelines that expand depression screening for mothers

On Tuesday, a key panel of experts issued updated depression screening guidelines for American adults, including— for the first time— pregnant women. While screening for depression during and after pregnancy may be standard in some states, the United States Preventive Services Task Force (USPTF), a panel appointed by the Department of Health and Human Services, now formally supports that advice.

For the health of America’s future generations and our mothers today, I strongly agree. While some critics may argue the questioning could consume too much of doctors’ time—or that such a screening would pose a privacy issue—it’s important to understand that a mother’s mental state can have a huge effect on her own health, as well as her child’s immediate and future health.

Depression during pregnancy is a bigger problem than many people may realize. Depending on the geographical area, at least 15 to 20 percent of women report depressive symptoms while pregnant or postpartum. Poor mental health can lead to multiple issues, from inadequate nutrition, to obesity and Type 2 diabetes— all conditions that affect mothers and their children. Not to mention, depression involves unnecessary stress that could also lead to poor fetal growth.

Beyond that, other studies have tied mothers’ depression during pregnancy to a greater incidence of depression, asthma and risky behavior for their children when they’re older. While people who are skeptical of this recommendation may say such screening will prove fruitless, questions surrounding depression are important ones to ask if only for the sake of our children’s future health.

The USPTF recommended that, for pregnant women, doctors carry out this screening using the standard Edinburgh Postnatal Depression Scale (EPDS), and that “all positive screening results should lead to additional assessment that considers severity of depression and comorbid psychological problems (e.g. anxiety, panic attacks, or substance abuse), alternate diagnoses, and medical conditions).”

However, the task force did not specify the particular clinicians who should conduct this screening, nor how often they ought to carry it out. It also doesn’t provide definite advice on what to prescribe women who are diagnosed with depression during pregnancy or postpartum, but it stated that cognitive behavioral therapy as well as psychotherapy has shown positive results. Antidepressant use is another option, though it may lead to adverse health effects for children, so women should consult their doctors before taking one.

Regardless of what treatment a doctor may prescribe, I would encourage my fellow physicians to follow the USPTF’s advice. The group’s previous recommendation, which was issued in 2009, only applied for American adults if hospitals felt they had the staff necessary to carry out such questioning, but the new guidelines recommend that doctors make time for the screening regardless. The guidelines have never before mentioned screening during or after pregnancy, which was a major shortcoming. I strongly feel that the latest update is a victory not only for pregnant mothers both current and future, but also for their unborn children.