A risk prediction tool to identify pregnant women at high risk of postnatal depression

Postnatal depression is very common, around 10 – 15% of women are affected within the first year of giving birth. For a long time it was thought that postnatal depression was different from other types of depression and possibly related to changes in the hormones after birth. However, views have changed and recent research suggests that there are strong links between postnatal depression and previous episodes of depression both in pregnancy and earlier life. Postnatal depression may have severe consequences for both mother and child and a recent report also estimated that it carries a high cost to society.

The clinical guidelines (NICE) on mental health in pregnancy and after birth recommend that health care professionals should ask simple questions about current and past histories of depression, anxiety, alcohol and illicit drug use as part of a general discussion about mental health and wellbeing in this period and some women may be referred for further treatment for their mental health.

In this project we will use existing data from women's electronic health records to develop a simple risk prediction tool for use during pregnancy to identify women at high risk of postnatal depression. Our risk score will combine the risks associated with a range of factors recorded in the women's primary care notes (for example previous history of depression or anxiety, antidepressant treatment, history of alcohol problems and illicit drugs, use of IVF for conception, relationship problems) into a single estimate - which will provide the percentage chance of getting postnatal depression within the first year after delivery. This will help both health care professionals and the women to identify early symptoms and give opportunities for early intervention and support for women who are at high risk of postnatal depression.

Amount awarded: £68,078