Combining the antenatal risk questionnaire and the Edinburgh Postnatal depression scale as a psychosocial risk assessment tool in Danish antenatal care. A descriptive study

Objectives: To evaluate the Antenatal Risk Questionnaire (ANRQ) and the Edinburgh Postnatal Depression Scale (EPDS) as part of an integrated psychosocial risk assessment aiming to enhance triage for pregnant women needing extended care. Further, to examine differences in sociodemographic and psychosocial characteristics of the population. Methods: This descriptive study was conducted at Department of Gynecology and Obstetrics, Copenhagen University Hospital – North Zealand, Denmark. Participants: Pregnant women at antenatal care level 1 or 2 at the North Zealand Hospital were invited to the study at their first-trimester ultrasound scan. The participants received an online questionnaire consisting of the ANRQ and the EPDS in gestational weeks 12–14, followed by an online questionnaire in 37–38 weeks of gestation, which included items related to sociodemographic characteristics and maternal mental health. Results: N = 774 pregnant women were invited to participate, of whom 424 (55 %) answered the ANRQ/EPDS questionnaire. Among them, n = 88 (21 %) had an ANRQ score ≥ 23, and n = 60 (14 %) scored ≥ 11 on the EPDS. A total of 17 (4 %) women were referred to extended care. Women with low scores on the ANRQ and the EPDS (ANRQ < 23, EPDS < 11) were more often highly educated. A history of mental problems was more strongly associated with a high ANRQ than a high EPDS. Conclusion: We identified women at increased risk of mental health problems who were not identified by the current triage process. Combining ANRQ and EPDS assessment may be an important part of a model for early identification of pregnant women with special needs.