NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Oxford University Clinical Academic Graduate School, Oxford, UK.
BMC Pregnancy Childbirth. 2023 Apr 27;23(1):263. doi: 10.1186/s12884-023-05518-4.
The perinatal period is a vulnerable time, with one in five women experiencing mental health problems. Antenatal and postnatal appointments are key contact points for identifying women in need of support. Since 2014, the UK National Institute for Health and Care Excellence (NICE) has recommended that all women be asked about their mental health at their antenatal booking appointment and early in the postnatal period. The aim of this study was to assess the proportions of women who reported being asked about their mental health during the perinatal period across consecutive national maternity surveys (NMS) in England and to evaluate sociodemographic disparities in who was asked.
Secondary analysis was performed on cross-sectional data from the NMS in 2014-2020. In each survey, women reported whether they had been asked about their mental health antenatally (during their booking appointment) and postnatally (up to six months after giving birth). The proportions of women in each survey who reported being asked about their mental health were calculated and compared according to key sociodemographic characteristics and across survey years. Logistic regression was conducted to identify disparities in who was asked.
The proportion of women who reported being asked about their mental health antenatally increased from 80.3% (95%CI:79.0-81.5) in 2014 to 83.4% (95%CI:82.1-84.7) in 2020, yet the proportion of women who reported being asked postnatally fell from 88.2% (95%CI:87.1-89.3) in 2014 to 73.7% (95%CI:72.2-75.2) in 2020. Ethnic minority women (aOR range:0.20 ~ 0.67) were less likely to report being asked about their mental health antenatally and postnatally across all surveys compared to White women. Women living in less socioeconomically advantaged areas (aOR range:0.65 ~ 0.75) and women living without or separately from a partner (aOR range:0.61 ~ 0.73) were also less likely to report being asked about their mental health, although there was less consistency in these disparities across the antenatal and postnatal periods and across surveys.
Despite NICE recommendations, many women are still not asked about their mental health during the perinatal period, particularly after giving birth. Women from ethnic minority backgrounds are less likely to be asked and these disparities have persisted over time.
围产期是一个脆弱的时期，五分之一的女性会经历心理健康问题。产前和产后预约是识别需要支持的女性的关键接触点。自 2014 年以来，英国国家卫生与保健优化研究所（NICE）建议在产前预约和产后早期询问所有女性的心理健康状况。本研究旨在评估英格兰连续国家产妇调查（NMS）中报告在围产期期间被询问心理健康状况的女性比例，并评估询问对象的社会人口统计学差异。
对 2014-2020 年 NMS 的横断面数据进行二次分析。在每个调查中，女性报告她们是否在产前（在预约时）和产后（分娩后六个月内）被询问过心理健康状况。根据关键社会人口统计学特征和调查年份计算每个调查中报告被询问心理健康状况的女性比例，并进行比较。采用 logistic 回归分析确定询问对象的差异。
报告在产前被询问心理健康状况的女性比例从 2014 年的 80.3%（95%CI：79.0-81.5）增加到 2020 年的 83.4%（95%CI：82.1-84.7），而报告在产后被询问心理健康状况的女性比例从 2014 年的 88.2%（95%CI：87.1-89.3）下降到 2020 年的 73.7%（95%CI：72.2-75.2）。与白人女性相比，少数民族女性（比值比范围：0.200.67）在所有调查中报告在产前和产后被询问心理健康状况的可能性较低。居住在社会经济地位较低地区的女性（比值比范围：0.650.75）和没有或单独与伴侣生活的女性（比值比范围：0.61~0.73）也不太可能报告被询问心理健康状况，尽管这些差异在产前和产后期间以及在不同调查中并不一致。
尽管有 NICE 的建议，但许多女性在围产期仍未被询问心理健康状况，尤其是产后。少数民族背景的女性不太可能被询问，而且这些差异随着时间的推移一直存在。
