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Cost-effectiveness of mental health screening in pregnancy


Authors: Kristýna Hrdličková 1,2 ;  Lucie Nováková 1;  Hana Němcová 2;  Antonín Šebela 2,3
Authors‘ workplace: Katedra psychologie, FF UK, Praha 1;  Národní ústav duševního zdraví, Klecany 2;  3. LF UK, Praha 3
Published in: Ceska Gynekol 2025; 90(1): 58-63
Category:
doi: https://doi.org/10.48095/cccg202558

Overview

Objective: To provide an overview of recent literature on the cost-effectiveness of mental health screening for women during pregnancy. Results: 1,988 publications were retrieved from databases, of which four were included in the systematic review. Models of care with screening are cost-effective compared with standard care without screening. Multi-level screening models are more cost-effective than single-level models. Effectiveness is affected by the number of false-positive cases, which decreases in multi-level models. Conclusion: Mental health screening in pregnancy appears to be cost-effective. We recommend its use in comprehensive health care for pregnant women in our country.

Keywords:

prenatal screening – mental health – cost effectiveness – prenatal care


Sources

1. Smith MV, Shao L, Howell H et al. Perinatal depression and birth outcomes in a Healthy Start project. Matern Child Health J 2011; 15 (3): 401–409. doi: 10.1007/s10995-010-0595-6.

2. Kammerer M, Marks MN, Pinard C et al. Symptoms associated with the DSM IV diagnosis of depression in pregnancy and post partum. Arch Womens Ment Health 2009; 12 (3): 135–141. doi: 10.1007/s00737-009-0062-9.

3. Okagbue HI, Adamu PI, Bishop SA et al. Systematic review of prevalence of antepartum depression during the trimesters of pregnancy. Open Access Maced J Med Sci 2019; 7 (9): 1555–1560. doi: 10.3889/oamjms.2019.270.

4. Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry 2017; 210 (5): 315–323. doi: 10.1192/bjp.bp.116.187179.

5. Gavin NI, Gaynes BN, Lohr KN et al. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005; 106 (5 Pt1): 1071–1083. doi: 10.1097/01.AOG.0000183597.31630.db.

6. Míguez MC, Vázquez MB. Risk factors for antenatal depression: a review. World J Psychiatry 2021; 11 (7): 325–336. doi: 10.5498/wjp.v11.i7.325.

7. Alder J, Fink N, Urech C et al. Identification of antenatal depression in obstetric care. Arch Gynecol Obstet 2011; 284 (6): 1403–1409. doi: 10.1007/s00404-011-1872-3.

8. Bonari L, Pinto N, Ahn E et al. Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 2004; 49 (11): 726–735. doi: 10.1177/070674370404901103.

9. Field T, Diego M, Hernandez-Reif M. Prenatal depression effects on the fetus and newborn: a review. Infant Behav Dev 2006; 29 (3): 445–455. doi: 10.1016/j.infbeh.2006.03.003.

10. Grote NK, Bridge JA, Gavin AR et al. A meta--analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010; 67 (10): 1012–1024. doi: 10.1001/archgenpsychiatry.2010.111.

11. Byatt N, Xu W, Levin LL et al. Perinatal depression care pathway for obstetric settings. Int Rev Psychiatry 2019; 31 (3): 210–228. doi: 10.1080/09540261.2018.1534725.

12. Guide for integration of perinatal mental health in maternal and child health services. Geneva: World Health Organization 2022.

13. Treatment and management of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 5. Obstet Gynecol 2023; 141 (6): 1262–1288. doi: 10.1097/AOG.0000000000005202.

14. Antenatal care. London: National Institute for Health and Care Excellence (NICE) 2021.

15. Rafferty J, Mattson G, Earls MF et al. Incorporating recognition and management of perinatal depression into pediatric practice. Pediatrics 2019; 143 (1): e20183259. doi: 10.1542/peds.2018-3259.

16. Šebela A, Hanka J, Mohr P. Etiologie, rizikové faktory a metody prevence poporodní deprese. Ceska Gynekol 2018; 83 (6): 468–473.

17. Waqas A, Koukab A, Meraj H et al. Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence. BMC Psychiatry 2022; 22 (1): 54. doi: 10.1186/s12888- 022-03694-9.

18. Trevethan R. Sensitivity, specificity, and predictive values: foundations, pliabilities, and pitfalls in research and practice. Front Public Health 2017; 5: 307. doi: 10.3389/fpubh.2017.00307.

19. Sambrook Smith M, Cairns L, Pullen LS et al. Validated tools to identify common mental disorders in the perinatal period: a systematic review of systematic reviews. J Affect Disord 2022; 298 (Pt A): 634–643. doi: 10.1016/j.jad.2021.11.011.

20. Angevine PD, Berven S. Health economic studies: an introduction to cost-benefit, cost--effectiveness, and cost-utility analyses. Spine (Phila Pa 1976) 2014; 39 (22 Suppl 1): S9–S15. doi: 10.1097/BRS.0000000000000576.

21. McDougall JA, Furnback WE, Wang BC et al. Understanding the global measurement of willingness to pay in health. J Mark Access Health Policy 2020; 8 (1): 1717030. doi: 10.1080/20016689.2020.1717030.

22. Yang Y, Zheng R, Yang L et al. Decision tree- -Markov model of perinatal depression screening: a cost-utility analysis. Front Public Health 2024; 12: 1308867. doi: 10.3389/fpubh.2024.1308867.

23. Littlewood E, Ali S, Dyson L et al. Identifying perinatal depression with case-finding instruments: a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy). Southampton (UK): NIHR Journals Library 2018.

24. Heslin M, Jin H, Trevillion K et al. Cost-effectiveness of screening tools for identifying depression in early pregnancy: a decision tree model. BMC Health Serv Res 2022; 22 (1): 774. doi: 10.1186/s12913-022-08115-x.

25. Chambers GM, Botha W, Reilly N et al. The clinical performance and cost-effectiveness of two psychosocial assessment models in maternity care: the perinatal integrated psychosocial assessment study. Women Birth 2022; 35 (2): e133–e141. doi: 10.1016/j.wombi.2021.05.007.

26. Dubber S, Reck C, Müller M et al. Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy. Arch Womens Ment Health 2015; 18 (2): 187–195. doi: 10.1007/s00737-014-0445-4.

27. O‘Higgins M, Roberts IS, Glover V et al. Mother-child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks. Arch Womens Ment Health 2013; 16 (5): 381–389. doi: 10.1007/ s00737-013-0354-y.

ORCID autorů

K. Hrdličková 0000-0002-8039-290X

A. Šebela 0000-0002-1063-7772

Doručeno/Submitted: 28. 9. 2024

Přijato/Accepted: 10. 10. 2024

Mgr. BcA. Kristýna Hrdličková

Národní ústav duševního zdraví

Topolová 748

250 67 Klecany

kristyna.hrdlickova@nudz.cz

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology


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