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Medical/Surgical/Diseases/Complications

Poster Session 2

(448) Comparing Generalized Anxiety Disorder-7 to Edinburgh Postnatal Depression anxiety- 3 scale in antepartum anxiety screening

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:  
Presently, there is no singular universally recommended screening tool for peripartum anxiety disorders. Our aim was to compare the Generalized Anxiety Disorder – 7 questionnaire (GAD-7) and the Edinburgh Postnatal Depression Scale (EPDS-3) in antepartum anxiety screening among underserved patients living in an urban region. We hypothesized these standardized instruments would be equivalent. 

Study Design: This was a secondary analysis of a prospective observational study that screened for anxiety symptomatology at a prenatal care clinic in a large, inner-city healthcare system. Enrolled patients completed the GAD-7 and EPDS-3 questionnaires at the first prenatal visit. Those with a positive GAD-7 score ( ≥ 10) were then referred to a behavioral health counselor for further evaluation and treatment. Patients with multiple gestations, congenital anomalies, or those who established care after 34 weeks were excluded from this analysis. Study outcomes of GAD-7 and EPDS-3 scores were compared using the Pearson correlation.

Results: Between Sept 2020 and December 2022, a total of 1794 patients completed the GAD-7 and the EPDS-3 surveys. Of these, 267 (15%) patients had a positive GAD-7 score ( ≥ 10) and 315 (17%) had a positive EPDS-3 score ( ≥ 5). The Pearson correlation of 4337 paired observations was 0.338 (CI 0.311, 0.364). The mean score of the GAD-7 overlaps with the confidence interval for EPDS-3 and vice versa; therefore, the two screens are equivalent in their likelihood of positivity (Figure).

Conclusion: This study validates the use of the EPDS-3 screen as an equivalent screening tool to GAD-7 in detecting anxiety symptomatology in pregnancy. Given the simple nature of limited screening questions, this information may facilitate deployment of universal screening among resource limited settings.