Perinatal Depression: AAP Policy Statement on Recognition and Management
Am Fam Physician. 2019 Oct 1;100(7):443-444.
Author disclosure: No relevant financial affiliations.
Key Points for Practice
• Perinatal depression, which includes postpartum depression, is the most common obstetric complication and is associated with poor infant care and developmental issues.
• The one-, two-, four-, and six-month well-child visits provide an opportunity to screen mothers for postpartum depression.
• Screening is recommended via the Edinburgh Postpartum Depression Scale or the Patient Heath Questionnaire at these visits.
From the AFP Editors
Perinatal depression, defined as a major or minor depressive disorder in which an episode happens during pregnancy or within the first year of birth, is the most common complication in patients receiving obstetric care. Perinatal depression has an annual incidence of 12%, with up to 18% of women experiencing postpartum depressive symptoms. Postpartum depression has a prevalence of up to 25% in men, which can reach 50% if the mother also has postpartum depression.
Postpartum depression can affect the entire family. It has been linked to incorrect medical treatment of the infant, decreased breastfeeding duration, family dysfunction, and a greater risk of abuse or neglect, and can result in adverse effects to the brain development of infants that can determine lifetime physical and mental health. Infants who grow up with a mother experiencing significant depression are at risk of toxic stress and subsequent problems with social interaction, language, cognition, and social-emotional development. Other consequences linked to unmanaged maternal depression include not using injury prevention protocols (e.g., car safety seats, electrical outlet covers) and poor management of the child's chronic conditions (e.g., asthma). The child may even withdraw from daily activities and avoid interactions, putting him or her at risk of failure to thrive or attachment disorders.
Despite the adverse effects and outcomes associated with maternal depression, fewer than one-half of pediatricians report screening mothers for postpartum
Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.
This series is coordinated by Sumi Sexton, MD, editor-in-chief.
A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.
Copyright © 2019 by the American Academy of Family Physicians.
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