Exploring the postpartum adjustment questionnaire as a predictor of postpartum depression

Objective: To evaluate the usefulness of the Postpartum Adjustment Questionnaire in predicting symptoms of postpartum depression as measured by scores from the Postpartum Depression Screening Scale. Design: Prospective descriptive. Setting: Mid-sized urban regional medical center. Participants: A convenience sample of 200 English-speaking postpartum women. Main Outcome Measures: Postpartum Depression Screening Scale scores and demographic data obtained at 6 weeks postpartum were compared with Postpartum Adjustment Questionnaire scores obtained before women were discharged from the hospital following delivery. Results: Using the total Postpartum Adjustment Questionnaire score, a cut point of 4 or higher was found to have the best positive predictive power in predicting postpartum depression symptoms. However, similar results were seen when 1 question from the Postpartum Adjustment Questionnaire was used rather than the entire survey. Overall, the Postpartum Adjustment Questionnaire had a moderate correlation (.28) with Postpartum Depression Screening Scale scores. Conclusion: The Postpartum Adjustment Questionnaire may be a valid predictor of postpartum depression, although it will identify only about 40% of women who develop this condition. Using a single question to identify women at risk for postpartum depression offers a cost-effective alternative to the complete questionnaire. Further studies with larger, multiethnic samples are needed before conclusions can be drawn and definitive recommendations for practice made.