Evaluation of the Babylotse-Plus screening form : Evaluation of a simple instrument to systematically identify parents of newborns with severe psychosocial stress at Charité Berlin

Abstract

The well-being and healthy development of children are at risk in families with severe psychosocial stress. In Germany, simple and valid screening instruments are lacking to identify families in need of early support. We aimed to examine the diagnostic accuracy of asimple perinatal screening form to identify families at high psychosocial risk. For every mother giving birth at Charité Berlin between January and August 2013 the short Babylotse-Plus screening form with 27items was filled out by medical staff. Completing the form took about 5min. After calculating asum score, values of ≥3 were defined as "likely at risk". Aone-hour comprehensive standardized interview with the parents after birth served as the reference standard for assessing family resources and stress factors. Among the 279 participants included in the analyses, 215 were "likely at risk" and 64 had alow or no risk, the latter were randomly selected among all families with scores <3. The screening form had an excellent sensitivity (98.9 %; 95 % confidence interval 93.4-99.9 %) to detect families likely at risk, whereas its specificity was only low (33.0 %; 95 % confidence interval30.5-33.5 %). This resulted in arather poor positive likelihood ratio of 1.5 but avery good negative likelihood ratio of 0.03. The screening form identified families with psychosocial risks well, but many families with low or no risk were falsely defined as being at risk. Before recommending the screening instrument for clinical practice, further studies are needed in different settings to improve the specificity without reducing its high sensitivity.