Depression experienced during pregnancy or early motherhood (perinatal depression) is an important category of depression in its own right. Perinatal depression affects up to 20% of women and can lead to a range of adverse outcomes for the mother and the developing child. Despite these adverse consequences, less than 50% of cases of perinatal depression are detected by healthcare professionals in routine clinical practice. In 2007, the National Institute for Health and Care Excellence (NICE) recommended the use of ultra-brief screening questions (2-3 items) to aid the identification of perinatal depression during the perinatal period. However, this recommendation was made in the absence of any definitive validation studies of these ultra-brief questions (often referred to as the ‘Whooley questions’) in a perinatal population.
The BaBY PaNDA study is embedded within the wider BaBY cohort (a pregnancy and birth cohort). The study aims to prospectively validate the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) against a diagnostic gold standard during pregnancy (around 20 weeks pregnancy) and the early postnatal period (around 3-4 months after birth). The study will also determine the acceptability of these depression screening instruments to women (both during pregnancy and the first postnatal year) and to healthcare professionals. The cost-effectiveness of the Whooley questions and the EPDS for routine screening for perinatal depression in maternity services will be determined. Secondary objectives aim to determine whether there is an optimum time to screen for perinatal depression; and will examine the co-existence of depressive symptoms alongside common mental health problems.
The study will fill an important evidence gap regarding the diagnostic utility of depression screening tools (the Whooley questions and the EPDS) in a perinatal population. This will enable the NHS to plan services accordingly and make informed decisions on the basis of screening results.