An Update on Prevalence and Trajectories of Perinatal Anxiety and Depression: Electronic Medical Records Analysis in a Large Hospital System

Objective: Perinatal depression and anxiety are common, underdiagnosed, undertreated, and increase the risk of poor maternal and infant outcomes. There is a need to accurately estimate prevalence and persistence of these disorders to inform development of scalable and timely interventions. We aimed to estimate screening rates, prevalence and persistence of perinatal depression and anxiety in a large diverse sample. Methods: We analyzed data from medical records of 27,393 women who gave birth at NewYork-Presbyterian hospital between 12-01-2020 and 02-01-2024. Our final sample included 3051 women who completed a depression and/or anxiety screening within 1 year pre- and post-delivery (PHQ-9, GAD-7, and EPDS). Mixed-effects models examined predictors of severity persistence over time (i.e. age, ethnicity, race, marital status, months pre-post-birth, and mental health visits). Results: Screening rates for anxiety (GAD-7), depression (PHQ-9), and perinatal depression (EPDS) were 2%, 3%, and 9% respectively. Screening rates for perinatal depression increased from 1% to 14% after 3 clinics covering half of the births mandated screening. Women reported moderate anxiety severity (peaking shortly post-delivery and declining after), and low to moderate depression severity (22% clinically significant depression), with 9% of women endorsing suicidal ideation. Mental health services were associated with faster reduction in depression over time. Conclusion: In this diverse sample, 1 of 5 perinatal women experienced significant depression symptoms, underscoring the need for mandatory routine screening. Faster depression reduction among women receiving mental health services, along with the peak in anxiety shortly after birth, highlights the potential impact of timely postpartum psychological interventions. Together, our results highlight the imperative to screen, diagnose and treat perinatal depression and anxiety disorders.