Recommended Citation
Luff A, Rivelli A, Noah A, Malloy E, Mishra R, Fitzpatrick V. Language-Related Differences in Prenatal Depression Screening, 2019-2024. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
The American College of Obstetricians and Gynecologists issued its first recommendation for universal prenatal depression screening (PDS) in 2015 and reinforced this opinion in 2018. In 2019, the National Committee for Quality Assurance added Prenatal Depression Screening and Follow-up as a quality measure. Language can be a barrier to receipt of recommended screenings.
Purpose:
To evaluate how language preference was associated with uptake of PDS following updated recommendations.
Methods:
This retrospective cohort included people who received prenatal care (PNC) for delivery at an Advocate Midwest facility between 2019 and 2024. We identified PDS through the presence of a depression screening instrument in the electronic health record during the PNC period. We used logistic regression with robust clustered standard errors to account for patients contributing multiple deliveries and calculated marginal probabilities of receiving PDS. An interaction term between language and year was used to assess whether the relationship between preferred language and PDS differed by year of delivery, controlling for maternal age, race/ethnicity, insurance, parity, gestational age, singleton versus multiple gestation, and state of PNC.
Results:
Of 99,526 deliveries, 37% received most prenatal care in Illinois and 63% in Wisconsin. Patients reported 76 preferred languages, reported as English (94%), Spanish (3%), and Another Language (3%) The interaction between language and year was statistically significant (p<0.001). In 2019, marginal probabilities of PDS were similar across groups: English 0.50 (95% CI, 0.49–0.51), Spanish 0.48 (95% CI, 0.41–0.56), and Another Language 0.50 (95% CI, 0.42–0.58). These probabilities diverged over time. By 2024, the probability of screening increased to 0.81 (95% CI, 0.80–0.81) for English-language preference patients, 0.66 (95% CI, 0.63–0.70) for Spanish-language preference patients, and 0.71 (95% CI, 0.68–0.74) for patients with another preferred language.
Conclusion:
PDS increased from 2019 to 2024, but improvements were not uniform across language groups, resulting in larger screening gaps by 2024 for patients with non-English language preference. Potential contributors include availability of validated instruments in preferred language, interpreter integration at screening, and documentation workflows.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Language-Related Differences in Prenatal Depression Screening, 2019-2024
Background/Significance:
The American College of Obstetricians and Gynecologists issued its first recommendation for universal prenatal depression screening (PDS) in 2015 and reinforced this opinion in 2018. In 2019, the National Committee for Quality Assurance added Prenatal Depression Screening and Follow-up as a quality measure. Language can be a barrier to receipt of recommended screenings.
Purpose:
To evaluate how language preference was associated with uptake of PDS following updated recommendations.
Methods:
This retrospective cohort included people who received prenatal care (PNC) for delivery at an Advocate Midwest facility between 2019 and 2024. We identified PDS through the presence of a depression screening instrument in the electronic health record during the PNC period. We used logistic regression with robust clustered standard errors to account for patients contributing multiple deliveries and calculated marginal probabilities of receiving PDS. An interaction term between language and year was used to assess whether the relationship between preferred language and PDS differed by year of delivery, controlling for maternal age, race/ethnicity, insurance, parity, gestational age, singleton versus multiple gestation, and state of PNC.
Results:
Of 99,526 deliveries, 37% received most prenatal care in Illinois and 63% in Wisconsin. Patients reported 76 preferred languages, reported as English (94%), Spanish (3%), and Another Language (3%) The interaction between language and year was statistically significant (p<0.001). In 2019, marginal probabilities of PDS were similar across groups: English 0.50 (95% CI, 0.49–0.51), Spanish 0.48 (95% CI, 0.41–0.56), and Another Language 0.50 (95% CI, 0.42–0.58). These probabilities diverged over time. By 2024, the probability of screening increased to 0.81 (95% CI, 0.80–0.81) for English-language preference patients, 0.66 (95% CI, 0.63–0.70) for Spanish-language preference patients, and 0.71 (95% CI, 0.68–0.74) for patients with another preferred language.
Conclusion:
PDS increased from 2019 to 2024, but improvements were not uniform across language groups, resulting in larger screening gaps by 2024 for patients with non-English language preference. Potential contributors include availability of validated instruments in preferred language, interpreter integration at screening, and documentation workflows.
Affiliations
Advocate Aurora Research Institute, Wake Forest School of Medicine, Aurora UW Medical Group, Aurora Sinai Medical Center, Advocate Illinois Masonic Medical Center