Improving Developmental Outcomes by Implementing Postpartum Depression Screenings in the Neonatal Intensive Care Unit

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Kriz, Margaret
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Neonatal , NICU , Neonatal Intensive Care Unit , Postpartum Depression , Postnatal Depression , Postpartum Mental Health and Anxiety Disorder , PMAD , Postpartum Depression Screening
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Purpose: This project aims to implement postpartum mood and anxiety disorders (PMAD) screening at one, two, four-, and six-month intervals in a Neonatal Intensive Care Unit (NICU) at a major Midwest Children's Hospital using the PHQ-9 and GAD-7 screening tools. Background: PMAD affect 80% of women in the United States. The incidence is significantly increased in NICU families. Undiagnosed and untreated PMAD can cause undesirable neurodevelopmental outcomes for NICU graduates. It has been shown that early identification of PMAD and intervention can mitigate associated neonatal morbidities. Participants/Setting: The project occurred in the NICU at Children's Hospital of Minnesota – St. Paul. The participants consisted of 49 NICU parents. Methods: Prior to project implementation, PMAD screens were performed via face-to-face interviews with parents subjectively identified as at-risk for PMAD. This project changed the process by instituting PMAD screenings using the PHQ-9 and GAD-7 to parents at one, two, four, and six-month intervals. Data regarding the incidence of PMAD, referral rates, and parent demographics were collected pre- and post-implementation and compared for differences. Pre-implementation data were collected for five months, and post-implementation for one month. The main goal was to increase the rates of screenings and referrals. Result: Prior to the institution of screening tools, 41% of parents were screened for PMAD. Of the screened parents, 64% were referred to a mental health provider per a subjective assessment. Comparatively, after implementation of the screening tool, 76% of parents with one- and two-month-old infants were screened. Of those parents, 57% with high screening scores were referred to a mental health provider. Conclusion: The data indicated that this project has helped increase referral rates and attention to PMAD. However, further data collection is necessary for adequate comparison since post-implementation data collection was time constrained. Data collection will continue through the end of 2023, and further data analysis will be necessary to determine the efficacy of PMAD screening tools.
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