ArticleInternational journal of environmental research and public health2022
Construct Validity and Responsiveness of Instruments Measuring Depression and Anxiety in Pregnancy: A Comparison of EPDS, HADS-A and CES-D.
Article in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Pilates during pregnancy for maternal musculoskeletal pain and discomfort: a systematic review and meta-analysis.BMJ open · 2026Pooled it
- Meta-analysis of association between caesarean section and postpartum depression risk.Frontiers in psychiatry · 2024Pooled it
- App-based interventions for the prevention of postpartum depression: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2023Pooled it
- Effectiveness of a Mobile Breastfeeding Monitoring Tool Among Mothers in WeChat Groups on Breastfeeding Exclusivity and Self-Efficacy: Intention-to-Treat and Per-Protocol Analyses of a Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Differential trajectories of depression symptoms during pregnancy and prospective associations with postpartum eating disorder symptoms and cardiovascular health behaviors.Archives of women's mental health · 2026Article
- In Search of a Global Distress Measurement Instrument for Perinatal Use: Testing Depression Anxiety Stress Scales Short Forms with Swedish Pregnant and Postpartum Women.Healthcare (Basel, Switzerland) · 2026Article
- Food insecurity and postnatal depression: the mediating effect of perceived social support among women in Khayelitsha, South Africa.Social psychiatry and psychiatric epidemiology · 2026Article
- Assessing potential added benefits of trauma-focused content to a guided low-intensity psychoeducational intervention for perinatal women: A propensity score-matched analysis of a nonrandomized trial.Global mental health (Cambridge, England) · 2026Article
- Understanding the link between maternal childhood maltreatment and mother-infant bonding: postpartum depressive symptoms as a mediator.European journal of psychotraumatology · 2025Article
- Rurality, socioeconomic status, and psychosocial health outcomes during pregnancy.BMC pregnancy and childbirth · 2025Article
- Oral microbiome composition is associated with depressive symptoms during pregnancy.Brain, behavior, & immunity - health · 2025Article
- Neurodevelopmental Impact of Maternal Postnatal Depression: A Systematic Review of EEG Biomarkers in Infants.Children (Basel, Switzerland) · 2025Review
- Associations Between Adverse Childhood Experiences and Prenatal Mental Health in the French EDEN Cohort: Cumulative, Person-Centered, and Dimensional Approaches.Depression and anxiety · 2025Article
- Association between phthalate exposure and sleep quality in pregnant women: Results from the Korean Children's Environmental Health Study with repeated assessment of exposure.Environmental epidemiology (Philadelphia, Pa.) · 2024Article
- Maternal psychological distress and temperament traits in children from infancy to late childhood.JCPP advances · 2024Article
- Prenatal mental health and emotional experiences during the pandemic: associations with infant neurodevelopment screening results.Pediatric research · 2024Article
- Vitamin D Levels and Depressive Symptoms during Pregnancy: A Prospective Pregnancy Cohort Study.Depression and anxiety · 2024Article
- A Psychometric Study of the Perinatal Assessment of Maternal Affectivity (PAMA) for the Screening of Perinatal Affective Disorders in Mothers.Healthcare (Basel, Switzerland) · 2023Article
- Maternal per- and poly-fluoroalkyl substances exposures associated with higher depressive symptom scores among immigrant women in the Chemicals in Our Bodies cohort in San Francisco.Environment international · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Depression and anxiety occur frequently in pregnancy and may have unfavourable consequences for mother and child. Therefore, adequate symptom measurement seems important. Commonly used instruments are the Center for Epidemiologic Studies Depression Scale (CES-D), the Edinburgh Postpartum Depression Scale (EPDS), and the Hospital Anxiety and Depression Scale, anxiety subscale (HADS-A). We compared the (1) structural and (2) longitudinal validity of these instruments. The data originated from a study on the effectiveness of an Internet intervention for pregnant women with affective symptoms. (1) A confirmatory factor analysis was used to estimate the construct validity. The theoretical factorial structure that was defined in earlier studies of the CES-D and the EPDS, but not the HADS-A, could be sufficiently replicated with acceptable CFI and RMSEA values. (2) Since there were two measurements in time, the hypotheses concerning plausible directions of the change scores of subscales that were (un)related to each other could be formulated and tested. In this way, longitudinal validity in the form of responsiveness was estimated. Ten of sixteen hypotheses were confirmed, corroborating the longitudinal validity of all constructs, except anhedonia, probably due to inconsistent conceptualization. The HADS-A seems less suitable to screen for anxiety in pregnancy. Anhedonia needs better conceptualisation to assess the change of symptoms over time with the CES-D and the EPDS.
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