School of Medicine, University of California, San Francisco, CA, USA.
Benioff Children's Hospital Oakland, University of California, San Francisco, CA, USA.
J Perinatol. 2021 Aug;41(8):1811-1824. doi: 10.1038/s41372-021-01005-w. Epub 2021 Mar 10.
This systematic review evaluated the feasibility of implementing universal screening programs for postpartum mood and anxiety disorder (PMAD) among caregivers of infants hospitalized in the neonatal intensive care unit (NICU). Four moderate quality post-implementation cohort studies satisfied inclusion criteria (n = 2752 total participants). All studies included mothers; one study included fathers or partners. Screening included measures of depression and post-traumatic stress. Screening rates ranged from 48.5% to 96.2%. The incidence of depression in mothers ranged from 18% to 43.3% and was 9.5% in fathers. Common facilitators included engaging multidisciplinary staff in program development and implementation, partnering with program champions, and incorporating screening into routine clinical practice. Referral to mental health treatment was the most significant barrier. This systematic review suggests that universal PMAD screening in NICUs may be feasible. Further research comparing a wider range of PMAD screening tools and protocols is critical to address these prevalent conditions with significant consequences for parents and infants.
本系统评价评估了在新生儿重症监护病房 (NICU) 住院婴儿的照料者中实施产后情绪和焦虑障碍 (PMAD) 普遍筛查计划的可行性。四项中等质量的实施后队列研究符合纳入标准(总参与者 2752 人)。所有研究均纳入母亲;一项研究纳入了父亲或伴侣。筛查包括抑郁和创伤后应激障碍的测量。筛查率从 48.5%到 96.2%不等。母亲的抑郁发生率从 18%到 43.3%不等,父亲的抑郁发生率为 9.5%。常见的促进因素包括让多学科工作人员参与方案的制定和实施、与方案拥护者合作、以及将筛查纳入常规临床实践。向心理健康治疗机构转介是最大的障碍。本系统评价表明,在 NICU 中进行普遍的 PMAD 筛查可能是可行的。进一步研究比较更广泛的 PMAD 筛查工具和方案对于解决这些对父母和婴儿都有重大影响的普遍疾病至关重要。