… "We have been screening at Magee almost four years now," added Dr. Wisner, an investigator at Magee Womens Research Institute and a multidisciplinary professor at the University of Pittsburgh.
"What we found is roughly 14 percent are positive for [postpartum] depression, so that's our rate in Pittsburgh, actually 14.1 percent," Dr. Wisner said.
"Of women that were in that 14.1 percent, when we talked to them and asked when did [the depression] begin, it began post-birth in a third of them, during pregnancy in a third, and before pregnancy in the other third."
The results were even more startling in a collaborative screening program Magee has with DuBois Regional Medical Center, located about 100 miles northeast of Pittsburgh. "Their postpartum depression rate is 20 percent now," she said. The DuBois center screens for depression during pregnancy, as well, and those numbers are even more troublesome than those of depressed women postpartum: 29 percent during the first prenatal visit.
"Again the rural area has a higher rate of positive screens," Dr. Wisner said. "Some population groups are going to have a higher rate, so it's a big problem."
For example, according to the University of Pittsburgh Office of Child Development, the rate of depression is higher among low-income families and more prevalent among parents who did not earn a high school diploma.
Depression can interfere with a woman's ability to care for her child. Interaction between mother and child can enhance a child's development if it is stimulating and responsive and nurturing.
"There is no question that if the mother is dealing with depression that you are going to have greater neonatal adaptation for the baby. There we're talking about what people typically refer to as bonding," said Ronald Thomas, director of the Division of Maternal-Fetal Medicine for the West Penn Allegheny Health System.
A doctor's ability to detect depression has limitations, according to neonatologist Nilima T. Karamchandani, chief of the Division of Neonatology, and medical director, of the Infant Apnea Center, both at the Western Pennsylvania Hospital.
Mother-infant bonding can be hard to measure, she said: "It is subjective to a certain point."
Entire families are affected, said Dr. David Wolfson, medical director of Children's Community Pediatrics, a network of pediatric practices and 104 pediatricians in the greater Pittsburgh area. It is affiliated with Children's Hospital.
"The issue is identifying these kids who are at risk because of parental depression. ... Anybody who thinks they're not seeing these families is just not recognizing [them]."
Each Children's Community practice either has access to, or has its own, behavioral therapist to provide family, child-centered, care.
The network also is planning a joint conference with women's health care specialists to learn more about postpartum depression and how to conduct screening. Dr. Wisner is among the speakers.
The local experts agreed more study was needed but that it shouldn't get in the way of screening and care.
"We know depression is not a good thing for the mother at least and probably not for the whole family, so let's give them the care while we do the research," Dr. Wolfson said.
Screening of pregnant and postpartum women can be as simple as observing their behavior, asking some questions, or administering any of several screening forms available for that use…
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