B3177 - Association between initial EPDS and long-term outcomes 19-02-2018 - 174222 - 24/10/2018

B number: 
B3177
Principal applicant name: 
Scott J Johnson | Medicus Economics LLC (USA)
Co-applicants: 
Elizabeth Chertavian, Si-Tien Mary Wang, Julia Bond
Title of project: 
Association between initial EPDS and long-term outcomes (19-02-2018 - 17:42:22)
Proposal summary: 

Postpartum depression (PPD) is a common occurrence among women who have just given birth. It has serious consequences for both the woman herself, and her family. PPD can have short term impacts, which can include feeling depressed, having difficulty performing normal tasks at home or work, and loss of interest in her new baby. It can also have long-term impacts, particularly for the children of women who are experiencing PPD. Research suggests that PPD and other mental health disorders affecting women who have just given birth can have serious economic implications, potentially costing up to £8.1 billion annually if the impacts on the children are considered (Bauer et al., 2014).
Recent research (Netsi et al, 2018) assessed long-term outcomes for mothers and offspring related to PPD using the ALSPAC data and found that severe PPD that persists past 8 months after birth is associated with an increased risk of negative outcomes for children on a large number of measures. We aim to build on their findings by evaluating whether early PPD (defined as PPD that occurs at the end of pregnancy and through 2 months following birth but which may resolve before the 8 month mark) similarly impacts long-term outcomes for women who have just given birth, their partners, and their children. We hope to track the impact of PPD on the likelihood of later depression for parents and children, as well as behavioral problems, antisocial behavior, psychosocial disorders, and academic achievement for children. We will use multivariate modeling techniques to account for factors that may confound the association.

Impact of research: 
Our analysis would estimate the relationship between early EPDS and study period EPDS, providing information pertinent to the potential impact of early interventions for PPD in women. Additionally, we can assess how early intervention could affect longer term outcomes in children. We would plan to publish the results in a high-impact journal to inform the research community. Further, the results of this analysis could be used in a cost-effectiveness model assessing a potential new treatment for PPD for the NHS. Sage Therapeutics is developing brexanolone, which is expected to be the first drug with an approved indication for PPD. Brexanolone has been granted Breakthrough Therapy designation by the Food and Drug Administration (FDA) in the US and PRIority MEdicines (PRIME) designation from the European Medicines Agency (EMA) for treatment of PPD. A cost-effectiveness model is being developed to assess the value of brexanolone versus the standard of care. A key component of that model is to link (a) the initial episode of maternal depression to (b) the long-term outcomes for mothers (e.g., continued depression) and their children (e.g., depression, mathematics scores) from PPD. The research questions that we plan to pursue directly involve this relationship.
Date proposal received: 
Wednesday, 12 September, 2018
Date proposal approved: 
Tuesday, 18 September, 2018
Keywords: 
Health Economics, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Learning difficulty, Mental health, Computer simulations/modelling/algorithms, Birth outcomes, Cohort studies - attrition, bias, participant engagement, ethics, Mothers - maternal age, menopause, obstetrics