Abstract
China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women at a high risk of PND using the Edinburgh Postpartum Depression Scale (EPDS) over multiple time points. We texted them and offered free consultations with a psychiatrist/psychologist. Among 248 screen-positive women, only three expressed interest and one attended the appointment. We surveyed the women about their reasons for declining referrals and preferred means of care. Of the 161 respondents, 128 (79.5%) indicated that they could cope with the condition without professional assistance and 142 (88.2%) chose their families as the preferred source of help. Only 15 (9.3%) chose professionals as their first option. Implementing a referral policy for screen-positive women would mean approximately one-third of women who gave birth in China would be eligible. Our result argues against referring all screen-positive women for professional services at this time. Interventions should instead build upon the tradition of family support in a more engaged response. These considerations are relevant for the implementation of national screening for PND in China.
Highlights
On 11 September, 2020, the National Health Commission of China (NHC) issued a work plan to introduce screening for depression during pregnancy and childbirth to routine pregnancy tests and postpartum visits [1]
If individuals ignored our initial alert, we resent it a week later. For those having no response after two alerts, we sent a text message connecting them to an anonymous online survey that we developed to understand their reasons for not seeking referrals
We found that symptoms consistent with perinatal depression (PND) were common among the Chinese women who participated in this study
Summary
On 11 September, 2020, the National Health Commission of China (NHC) issued a work plan to introduce screening for depression during pregnancy and childbirth to routine pregnancy tests and postpartum visits [1]. Depression during pregnancy and childbirth, known as perinatal depression (PND), is a public health problem that encompasses clinically significant depressive conditions occurring during pregnancy or within the first 4–6 weeks after delivery. The reported prevalence of PND in low- and middle-income countries is 15.6% antenatally and 19.8% postnatally [2]. In mainland China, the prevalence was estimated to be 16.3% [3]. Health agencies in the EU, the U.S, and other developed countries recommend regular screening of pregnant and post-partum women to detect symptoms suggestive of PND [7,8,9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International journal of environmental research and public health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
