Psychometric evaluation of the Czech Peripartum Depression Scale in pregnant and postpartum women

BACKGROUND: Pregnancy and the first postpartum year are periods of increased vulnerability to depressive symptoms with important consequences for women and their infants. Timely identification is crucial, and validated instruments for peripartum depression detection according to the current diagnostic criteria are needed. This study translated and evaluated the Czech version of the Peripartum Depression Scale (CZ-PDS). METHODS: In a cross-sectional online survey, 593 pregnant and postpartum women completed the CZ-PDS, the Edinburgh Postnatal Depression Scale and the Depression Anxiety Stress Scales-21, together with sociodemographic, obstetric and psychosocial questions. After removal of multivariate outliers, 550 participants (268 pregnant, 282 postpartum) were retained. Confirmatory factor analyses compared a nine-factor correlated model with hierarchical, bifactor and single-factor alternatives. Internal consistency, convergent and divergent validity and known-groups differences by psychiatric history were examined. RESULTS: The nine-factor correlated model showed excellent fit and outperformed hierarchical and bifactor models, which were also acceptable. However, the single-factor model had a poor fit. Internal consistency was excellent (Cronbach's alpha and omega ≥0.96). Convergent validity was supported by strong correlations with EPDS and DASS-21 depression scores. However, discriminant validity was only modest due to high correlations with DASS-21 anxiety and stress scores. Still, it was supported by the absence of associations with maternal age. Known-groups analyses showed significantly higher CZ-PDS scores among women with current or past mental health problems. CONCLUSION: The CZ-PDS appears to be a psychometrically robust, culturally adapted measure of peripartum depressive symptoms in Czech-speaking pregnant and postpartum women and can complement existing screening tools.