Introduction to Perinatal Depression
The 2019 American Academy of Pediatrics Policy Statement defines Perinatal depression (PND) is a major or minor depressive disorder, with an episode occurring during pregnancy or within the first year after the birth of a child. A major depressive episode during pregnancy and the first postpartum year, is estimated to occur in 12% to 19% of the general U.S. population. However, rates of PND are substantially higher among immigrant and U.S.-born Latinas living in the United States at 11% to 50%. African American women, whose estimates of PND range between 7% and 28%. Given the complex psychosocial risk factors among these groups, increased efforts to diagnose and treat Latinas and African American women are needed.
In addition, the risk is also higher with multiple births, preterm birth, and congenital or acquired physical or neurodevelopmental deficits in the infant. An infant in the environment of significant perinatal depression is at risk for toxic stress and its consequences. Perinatal depression (PND) is the most common obstetric complication in the United States. The AAP recommends advocacy and training for workforce development for healthcare professionals who care for young children and mother-infant dyads, and for promotion of evidence-based interventions focused on healthy attachment and parent-child relationships.
About the Curriculum
Participating in this curriculum will provide learners with a deep dive into perinatal depression and will enable health care professionals to engage in small group discussions and learn alongside others from across the country.
Traditional problem-based learning in medical education starts with a problem based on a medical case. The cases provide a framework for students to work together to learn, in a relevant way all they need to know. Depending on the learner's level and the objectives of the case the students take an active role in finding the information they need to address the patient. Some problem-based learning systems are designed to be completed over weeks, some in far less time. These cases are designed to move the learning through the information quickly but can be stretched out over multiple sessions if necessary. This method is designed to engage students in an active learning.
The learning objectives correspond with the Accreditation Council for Graduate Medical Education Core Competencies for residency training programs to fulfill requirements and set context within clinical learning environments for development of the skills, knowledge, and attitudes necessary to take personal responsibility for the individual care of patients. Upon successful completion of the curriculum, trainees will possess the following skills and knowledge when screening for, managing, and treating perinatal depression:
Practice-based Learning and Improvement: LO1 Learners will familiarize themselves with perinatal depression screening tools, including how to select an appropriate screening tool, interpret results, consider screening limitations, and counsel on results of a screen in the context of a well child and hospital visits.
Interpersonal and Communication Skills: LO2 Learners will be able to engage the caregiver in discussion and to counsel on protective factors for primary care intervention.
Medical Knowledge: LO3 Identify epidemiology of perinatal depression. Learners will be able to describe risk factors that increase perinatal depression, such as: social, psychological, and hormonal changes that occur.
Patient Care and Professionalism: LO4 Learn how to provide culturally sensitive, humble, and effective in office counseling for perinatal depression.
System-based Practice: LO5 Learners will be able to support and advocate for policies which promote perinatal depression screening, discussion, primary care intervention and referral/linkage as the norm in the medical community.
Patient Care and System-based Practice: LO6 Learners will identify and implement steps to build referral relationships with community resources, and coordinate services and referrals for the mother and the dyad, including co-management with infant and early childhood mental health professionals.
Medical Knowledge and Patient Care: LO7 Learners will be able to describe connection between perinatal depression and child development, and understand evidence-based interventions for the dyad.
The curriculum will be available on PediaLink
Marian Earls, MD, MTS
Zoey Goore, MD, MPH
Gerri Mattson, MD, MSPH, FAAP
Donna O'Malley, PhD, RN
Julie Winkelmann, RN, BSN