Quality of Life Assessments Across Baseline Postpartum Depression Symptom Severity: Results From the Junonia Study
Background: Postpartum depression (PPD) can impair functioning and quality of life (QoL). The Junonia study evaluated characteristics and QoL of patients with moderate or severe PPD symptoms at baseline.
Methods: Junonia is an ongoing, prospective, interventional cluster study evaluating risk parameters and impacts of PPD care coordination on diagnosis and treatment patterns at 18 US sites offering outpatient perinatal services. Enrollees are English-speaking women (18-55yrs) at risk for PPD (between 4wks-6mos postpartum; Edinburgh Postnatal Depression Scale [EPDS]≥10) assigned to coordinated care or standard practices. Cohorts with moderate (EPDS=14-18) or severe (EPDS>18) depressive symptoms at baseline were analyzed.
Results: Among 438 patients, cohorts with moderate (Nf144) or severe (Nf66) symptoms had mean(SD) baseline EPDS scores of 15.6(1.4) and 21.6(2.3), respectively. At baseline, cohorts with moderate vs. severe symptoms had no significant differences in prior history of depression (44.4% vs. 50.0%; p=0.45), anxiety (60.4% vs. 59.1%; p=0.86), or PPD (31.9% [23/72] vs. 34.3% [12/35]; p=0.81); number of prior pregnancies (p=0.99); and experience of complications during latest pregnancy (49.3% vs. 59.1%; p=0.19) or birth (40.3% vs. 54.5%; p=0.054).
Considering baseline QoL, cohorts differed significantly from population norms (mean=50, SD=10; p < 0.0001 for listed Medical Outcomes Survey SF-36 domains): emotional well-being (mean[SD]; moderate=38.3[6.8]; severe=32.3[6.5]), social functioning (moderate=38.9[9.0]; severe=31.4[9.2]), energy/fatigue (moderate=38.0[6.7]; severe=34.2[6.4]), and role limitation-emotional (moderate=41.0[8.9]; severe=36.3[5.7]).
Conclusion: Patients with moderate or severe PPD symptoms had similar baseline characteristics, with substantially lower QoL and functioning vs. population norms. Regardless of symptom severity, rapid intervention and consistent follow-up are imperative for all patients with moderate/severe PPD symptoms.
