'One in four pregnant women have mental health problems'

By Julie Griffiths on 04 January 2018 Maternal Mental health Prenatal Depression

According to a new study by King’s College London, a quarter of pregnant women have mental health problems.

It is the first UK study to examine the prevalence of mental health problems or mental disorders when seen by a midwife for pregnancy care.

The researchers recruited 545 pregnant women, over the age of 16, attending their antenatal booking appointment at an inner city maternity service in South-east London between November 2014 and June 2016.

They found that when interviewed with a diagnostic gold standard interview, one in four women had a mental illness – not only depression (found in 11%) and anxiety (found in 15%), but also eating disorders (2%), obsessive-compulsive disorder (2%), PTSD in just less than 1% and less commonly, bipolar disorder and other disorders.

The study went on to evaluate how well a two question screen (known as the Whooley questions) which is asked by midwives, identified these disorders and compared with a 10 item self-complete questionnaire known as the Edinburgh Postnatal Depression Scale (EPDS), and compared both methods with a gold standard diagnostic Interview.

The study revealed that the two-questions asked by midwives performed similarly well in identifying whether a woman had ‘any disorder’ compared with the 10 question self-complete EPDS measure.

There was also evidence that identification of depression was more difficult to identify in older women than younger women.

Report author Professor Louise Howard of King’s College London said: ‘In clinical practice, maternity professionals need to identify whether or not a woman has any mental disorder, not only mood disorders which until recently have been the main focus of concern.

‘This study supports the NICE recommendation that women should be asked, by a non-judgemental and supportive health professional, at all contacts in pregnancy and after birth about their emotional wellbeing and are given the opportunity to respond to these structured questions (the Whooley or the EPDS). A positive identification then needs to be followed by a clinical assessment by an appropriate health practitioner to establish the clinical diagnosis and appropriate intervention.’

The study was published in the British Journal of Psychiatry.