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Obstetric Quality and Safety

Poster Session 1

(303) Analyzing the Utility of Ecological Momentary Assessment in the Evaluation of Postpartum Depression

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Kay Roussos-Ross, MD

University of Florida College of Medicine Gainesville
University of Florida
Gainesville, FL, United States

Coauthor(s)

Tony S. Wen, MD

Professor, Maternal Fetal Medicine Chief
University of Florida
Gainesville, FL, United States
DV

Deepthi Varma, PhD

University of Florida
Gainesville, FL, United States
AG

Amie Goodin, PhD

University of Florida
Gainesville, FL, United States

Objective: Postpartum depression (PPD) affects up to 20% of women in the initial 12 months after delivery. Maternal suicide is a leading cause of maternal mortality in the United States. A smartphone-based application using ecological momentary assessment (EMA) technology was developed for monitoring and intervention of PPD during the initial 6 weeks after delivery. This innovative method allows for frequent evaluations and interventions when positive findings are noted.

Study Design: All postpartum English-speaking women, aged 18 and above, owning a smartphone, agreeing to download the app, and who delivered a liveborn neonate at a quaternary care academic hospital were offered participation in this prospective study. Enrollment occurred between November 2021 and June 2023. Participants received notifications to complete mood evaluations via marking “happy” or “sad” faces and by completing the Edinburgh Postpartum Depression Scale (EPDS) in the app. Following discharge, notifications were sent at least 3 times weekly in weeks 1 and 2, and once per week from weeks 3 to 6. When EPDS scores were >12, follow-up contact via phone was made where action was taken based on nurse assessment.

Results: A total of 1430 participants were enrolled, resulting in 3,552 assessments via the app. 232 participants reported feeling “sad” (16.2% of enrolled), and 189 were noted to have an EPDS score >12, which was considered positive and alerted the study team (13.2% of those enrolled). The outcomes of the alerts resulted in: 220 completed follow up contacts from a study nurse, 50 clinic referrals, 1 hospitalization, and 2 referrals to Labor & Delivery. Nearly a quarter (24.1%, or 53/220) of follow-up contacts from app positive screens resulted in clinical intervention.

Conclusion: The ability to monitor postpartum women continually and intervene in real-time allows for more rapid identification and management of PPD. This intervention may decrease undiagnosed PPD and lessen the mental health burden of new mothers. More studies are required to determine if this application is effective in decreasing maternal morbidity.