Is the 12-item General Health Questionnaire (GHQ-12) confounded by scoring method during pregnancy and following birth?

The GHQ-12 has been recommended as a reliable screening instrument for psychological distress in all clinical groups. The usefulness of the GHQ-12 was evaluated in pregnant women experiencing pre-labour rupture of membrane (PROM) at term. The GHQ-12 was administered to two groups of pregnant women presenting with term PROM over three observation points (baseline, at labour/prior to induction, 28 days post-delivery). The type of scoring method used had a significant impact on both interpretation of data and the relative prevalence of 'cases' in this study cohort. The use of the GHQ-12 as a screening instrument to determine psychological distress in women with PROM at term cannot be recommended due to confound of case determination by alternative scoring methods. A further study is required to determine the optimal threshold score for the GHQ-12 in this clinical population before the instrument can be seriously considered as a screening tool in pregnancy.