Thirty-seven studies were included in the review. The total number of participants was unclear. Sample size ranged from 23 to 876. Twelve studies were rated A for quality, 24 were rated B and one did not provide enough data for evaluation.
For antepartum depression (three studies), sensitivity of EPDS for major depression ranged from 73% (specificity 93%) to 100% (specificity 96%) and specificity ranged from 93% (sensitivity 73%) to 99% (sensitivity 78%).
For postpartum depression, sensitivity and specificity of different cut-off points showed marked heterogeneity between studies. Sensitivity ranged from 34% (specificity 97%) to 100% (specificity 51% to 93%) and specificity from 44% (sensitivity 90%) to 100% (sensitivity 55% to 67%). Positive likelihood ratios varied from 1.61 to 78. Other accuracy outcomes were reported.
Studies of non-English speaking populations showed a wider range of sensitivity and specificity values than those of English-speaking populations at a cut-off of 12/13 and a wider range of sensitivity values at a cut-off of 9/10.