Aleesha Jethwa

All Publications

• Patient outcomes following positive depression screening in a postpartum clinic: A single center retrospective cohort study. Medical research archives Jethwa, A. J., Guo, N., Harrison, N., Chakraborty, D., Mendoza, K., Kii, N., Carvalho, B., Panelli, D. M., Sultan, P. 2026; 14 (7)

  Abstract

  Depression screening using the Edinburgh Postnatal Depression Scale is commonly performed at the 6-week postpartum visit, yet subsequent referral patterns and clinical outcomes are incompletely characterized.A single center cohort study was conducted using electronic health records of patients with a completed depression screen at the 6-week postpartum clinic between 2014-2023. Exposure was categorized as screen negative (Edinburgh Postnatal Depression Scale 0-9) or screen positive (Edinburgh Postnatal Depression Scale ≥10) for depressive symptoms. Primary outcome: the proportion of new mental health referrals made (to social work and/or psychiatry services) following the 6-week postpartum depression screen up to 1 year after childbirth. Secondary outcomes: the proportion of patients referred to each specialty after 6 weeks and during the peripartum period (antenatal to 1 year postpartum); patient variables associated with specialty referral from 6 weeks to 1 year postpartum using a multivariable logistic regression model; timing of postpartum referrals after 6-week depression screening; and psychiatric (medications, hospitalizations, mental health diagnoses) and infant associated outcomes within 1 year of childbirth.Of 41,790 deliveries, 8,155 patients met inclusion criteria. 12.6% received a new mental health referral following 6-week postpartum depression screening up to 1 year after childbirth. After screening, social work and psychiatry referrals occurred in 4.7% and 3.7% of negative-screened patients and 37.1% and 19.5% of positive-screened patients, respectively. Across the peripartum period, social work and psychiatry referrals occurred in 8.6% and 17.5% of negative-screened patients, and 42.0% and 42.5% of positive-screened patients, respectively. Variables associated with referrals (6 weeks to 1 year postpartum) included divorced, separated and widowed marital status, ASA grade ≥3, delivery of a non-viable fetus, neonatal intensive care hospitalization, psychiatric diagnosis, and medication use. Referrals within 2 months postpartum were more frequent following positive screening compared to negative screening; Social Work (84% vs 49%); Psychiatry (53% vs 32%). Psychiatric medications, hospitalizations, mental health diagnoses and infant associated outcomes were more frequent following positive screening.Positive postpartum depression screening was associated with increased referrals to social work and psychiatry services; however, a critical gap persists between positive screening and specialty referral, diagnosis, and initiation of treatment. Findings support longitudinal mental health screening across the peripartum period.

  View details for DOI 10.18103/mra.2026.0389

  View details for PubMedID 42741740

  View details for PubMedCentralID PMC13573980

• Use of a single pain coping skills session (Empowered Relief) for outpatient postpartum pain following cesarean delivery: a pilot feasibility study. International journal of obstetric anesthesia Jethwa, A., Nguyen, N., Michel, G., Simons, L. E., Rabbitts, J., Panelli, D. M., Darnall, B. D., Sultan, P. 2026; 67: 105190

  Abstract

  Chronic pain after cesarean delivery affects 17% of patients which can impact quality of life. Interventions to prevent acute to chronic pain transition are limited. The primary aim of this study was to assess feasibility of Empowered Relief, a 2-hour pain skills session delivered by an instructor in the outpatient setting.Patients were screened and approached at the 6-week postpartum clinic visit for pain severity and interference using qualitative questions and a 0-10 numeric rating scale. Those with moderate to severe pain (numeric rating scale ≥ 4/10) were consented and randomized to intervention (Empowered Relief) or standard follow up care. The primary outcome was feasibility of the intervention. Secondary outcomes were changes in pain interference, severity, and catastrophizing at 12 weeks postpartum. Data is presented as median values with interquartile ranges.Of the 48 patients that were assessed for pain severity between July and November 2025, 4 (8%) reported ≥ 4/10 pain and were eligible; 44 (92%) were ineligible. Of 4 eligible cases for the intervention, 3 declined participation due to time commitment; one consented however, did not attend the intervention session. The trial was terminated due to low eligibility rate and inability to conduct the intervention. Pain interference > 0/10 was reported by 59% of patients (24/41). Median pain severity was 0 [0,3] and pain interference was 1 [0,1.25]. In 88% of cases, reported pain scores to the research team were higher than those reported to the clinical team.Using pain severity (with a threshold of ≥ 4/10 on the numeric rating scale) in the 6-week postpartum follow-up clinic setting resulted in insufficient sample of eligible patients to evaluate the Empowered Relief intervention. Future studies should consider inclusion criteria based on any pain interference or severity.

  View details for DOI 10.1016/j.ijoa.2026.105190

  View details for PubMedID 42349309

• The Methodology of Adapting a Single-Session Pain Skills Intervention (Empowered Relief®) for the Context of Peripartum Pain Jethwa, A., Takenoshita, M., Simons, L., Rabbitts, J., Sultan, P., Darnall, B. CHURCHILL LIVINGSTONE. 2026

  View details for DOI 10.1016/j.jpain.2025.106082

  View details for Web of Science ID 001746783200068