Stanhope Kaitlyn K, Galatan Joelle, Umerani Amal, Islam Rehnuma, Powers Abigail, Michopoulos Vasiliki, Lawley Megan, Leslie Sharon L, Suglia Shakira F
Emory University Rollins School of Public Health, Department of Epidemiology, 1518 Clifton Road NE Atlanta, 30329, Georgia; Emory University School of Medicine, Department of Gynecology and Obstetrics, 49 Jesse Hill Jr Drive SE, Atlanta, 30303, Georgia.
Emory University Rollins School of Public Health, Health Policy and Management, 1518 Clifton Road NE Atlanta, 30329, Georgia.
Midwifery. 2025 Sep;148:104530. doi: 10.1016/j.midw.2025.104530. Epub 2025 Jul 16.
Mental health is a key driver of maternal health, particularly in the postpartum period. Psychiatric screening may improve linkage to care and outcomes. Limited evidence exists beyond screening for depression.
The goal of this systematic review was to characterize the effects of systematic psychiatric and psychosocial screening on the identification, referral for, and resolution of postpartum mental health symptoms beyond depressive symptoms.
We identified studies that screened for psychiatric or psychosocial symptoms during pregnancy or postpartum and assessed at least one result of the screening in the postpartum year (e.g., diagnosis, linkage to care, resolution of symptoms). We searched six bibliographic databases on October 25, 2022 and again on December 15, 2023. Results were screened using Covidence. Two reviewers assessed each title/abstract and full text. We conducted a quality assessment using a modified version of the EPHPP (Effective Public Health Practice Quality Assessment Tool for Quantitative Studies).
Of 5758 initially eligible studies, we selected 47 which fit our criteria. The most common symptom type was anxiety (25), followed by life course trauma (7), general psychosocial screening (4), and posttraumatic stress disorder (6). Studies primarily assessed diagnostic accuracy, followed by referral to care as outcomes. We deemed most studies of low quality (80.8 %), primarily due to a lack of an unscreened control group for assessing screening effectiveness.
Postpartum screening is feasible and accurate for many psychiatric symptoms beyond depression. It is unclear whether it is effective in linking to care or improving postpartum outcomes.
心理健康是孕产妇健康的关键驱动因素，尤其是在产后阶段。精神科筛查可能会改善获得护理的机会及治疗效果。除了抑郁症筛查外，相关证据有限。
本系统评价的目的是描述系统性精神科和心理社会筛查对产后心理健康症状（不包括抑郁症状）的识别、转诊及症状缓解的影响。
我们纳入了在孕期或产后筛查精神科或心理社会症状，并在产后一年内评估至少一项筛查结果（如诊断、获得护理的机会、症状缓解）的研究。我们于2022年10月25日和2023年12月15日检索了六个文献数据库。使用Covidence对结果进行筛选。两名评审员评估每个标题/摘要和全文。我们使用改良版的EPHPP（定量研究的有效公共卫生实践质量评估工具）进行质量评估。
在最初符合条件的5758项研究中，我们选择了47项符合我们标准的研究。最常见的症状类型是焦虑（25项），其次是生命历程创伤（7项）、一般心理社会筛查（4项）和创伤后应激障碍（6项）。研究主要评估诊断准确性，其次是将转诊接受护理作为结局。我们认为大多数研究质量较低（80.8%），主要原因是缺乏用于评估筛查有效性的未筛查对照组。
产后筛查对于许多除抑郁症之外的精神科症状是可行且准确的。目前尚不清楚它在促进获得护理或改善产后结局方面是否有效。
