期刊
JOURNAL OF PSYCHOSOMATIC RESEARCH
卷 76, 期 6, 页码 433-446出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychores.2014.01.006
关键词
Depression; Screening; Pregnancy; Postpartum; Perinatal; Systematic review
类别
资金
- Canadian Institutes for Health Research [KRS-103274, KTE-102825]
- Canadian Institutes of Health Research
- Etablissement de Jeunes Chercheurs award from the Fonds de la Recherche en Sante Quebec
- Frederick Banting and Charles Best Canadian Graduate Scholarship - Master's Award from the Canadian Institutes of Health Research
- Master's Training Award from the Fonds de la Recherche en Sante Quebec
- McGill University Provost's Graduate Fellowship
- McGill University Principal's Graduate Fellowship
- McGill University Graduate Studies Fellowship
- Research Scholar Award from the Fonds de Recherche du Quebec - Sante (FRQ-S)
- National Institute for Health Research [05/39/06] Funding Source: researchfish
Objective: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or the postpartum period. Methods: Searches included the CINAHL, EMBASE, ISI, MEDLINE, and PsycINFO databases through April 1,2013; manual journal searches; reference list reviews; citation tracking of included articles; and trial registry reviews. RCTs in any language that compared depression outcomes between women during pregnancy or postpartum randomized to undergo depression screening versus women not screened were eligible. Results: There were 9,242 unique titles/abstracts and 15 full-text articles reviewed. Only 1 RCT of screening postpartum was included, but none during pregnancy. The eligible postpartum study evaluated screening in mothers in Hong Kong with 2-month-old babies (N = 462) and reported a standardized mean difference for symptoms of depression at 6 months postpartum of 0.34 (95% confidence interval = 0.15 to 0.52, P < 0.001). Standardized mean difference per 44 additional women treated in the intervention trial arm compared to the non-screening arm was approximately 1.8. Risk of bias was high, however, because the status of outcome measures was changed post-hoc and because the reported effect size per woman treated was 6-7 times the effect sizes reported in comparable depression care interventions. Conclusion: There is currently no evidence from any well-designed and conducted RCT that screening for depression would benefit women in pregnancy or postpartum. Existing guidelines that recommend depression screening during pregnancy or postpartum should be re-considered. (C) 2014 Elsevier Inc. All rights reserved.
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