Prevalence of postpartum depression in adolescents in an urban teen clinic

Authors: RAMOS, MELANIE - Baylor College Of Medicine; GONZALEZ DE CORCUERA, SOFIA - Baylor College Of Medicine; MIRABILE, YIMING - Children'S Nutrition Research Center (CNRC); MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); RAPHAEL, MEGHNA - Baylor College Of Medicine; GORDON, CATHERINE - National Institutes Of Health (NIH)

Submitted to: Maternal and Child Health Journal
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/14/2025
Publication Date: 9/15/2025
Citation: Ramos, M.W., Gonzalez De Corcuera, S., Mirabile, Y., Musaad, S.M., Raphael, M., Gordon, C.M. 2025. Prevalence of postpartum depression in adolescents in an urban teen clinic. Maternal and Child Health Journal. 29(11):1520-1527. https://doi.org/10.1007/s10995-025-04178-4.
DOI: https://doi.org/10.1007/s10995-025-04178-4

Interpretive Summary: Postpartum depression (PPD) is one of the most common complications of pregnancy with long-term consequences for women and their children if untreated. Universal PPD screening at well child visits in the first six months of life has been found to be successful in increasing PPD detection. This study aimed to determine the frequency of PPD screening and the factors that impact it in adolescents and young adults. Researchers examined 280 clinical charts of postpartum visits between 2017 and 2022 from a free safety net urban teen health clinic in Houston, Texas. The clinic serves adolescent patients ages 13–24 and operates nine locations across the city, including community-based family planning clinics and school-based clinics that are open to all community members. Results show that the mean time between delivery and the first postpartum visit was 60.8 days (ranging from 10–203 days). We found that 140 (52%) of postpartum patient encounters were screened for PPD using established measures for depression or anxiety. This is similar to screening rates described in publicly insured adult patients. A history of a mental health diagnosis was positively associated with screening. Following a change in clinic flow in 2020, screening increased. Screening was positively associated with a history of mental health diagnosis. This suggests screening protocols could be used to improve screening rates. Interventions are needed to increase screening in this population, such as community health care workers or social workers meeting with patients.

Technical Abstract: The purpose of this study was to determine the frequency of postpartum depression (PPD) screening, the prevalence of PPD, and the factors associated with PPD screening amongst adolescents and young adults (AYA) at a free urban teen clinic.  We conducted a retrospective chart review of postpartum visits at a free urban teen health clinic serving AYA ages 13-24. Two trained researchers extracted study data including patient demographics, pregnancy outcomes, time from delivery to first postpartum clinic visit, prenatal mental health diagnoses, and postpartum mental health assessments from charts between 2017 and 2022 with a postpartum visit billing code.  280 charts were retrieved from which nine were excluded. The majority of subjects identified as White and Hispanic or Latino. Ages ranged from 14 to 24 years and most were 18-24 at the time of the infant's birth. 103 (35.2%) were publicly insured and the remainder were uninsured. 140 (51.7%) of patients received PPD screening with the Edinburgh Postpartum Depression Screen or a validated alternative, though the rate of PPD screening significantly improved (p<0.00001) after clinic flow was changed in 2020. Of those screened (n=140), the rate of positive scores was 9.9%, lower than expected. Despite clinical recommendations, only just over half of AYA women had documented mental health screening at the time of postpartum visits. Rates of PPD in this sample were low. As PPD is an adverse childhood event with lifelong implications for the parent and child, efforts to improve PPD screening are warranted.