Mental health during pregnancy and early childhood: recommendations from evidence-based guidelines

Abstract

Abstract Background Mental health problems are common during pregnancy and after birth and are therefore often addressed in the context of antenatal and postnatal care. The project is an update of previous work and aimed at identifying and summarising screening and counselling recommendations from evidence-based guidelines. Mental health was defined broadly and included topics such as substance use and domestic violence. Methods Relevant guidelines were identified by searching 2 databases (G-I-N, TRIP Database) and websites of relevant institutions and professional societies. Guidelines, that were published or updated within the last 5 years and fulfilled methodological quality criteria, were included. Results A total of 52 guidelines from 16 different institutions fulfilled the inclusion criteria. The guidelines (predominantly) advocate the following mental health screenings: Interviewing about psychosocial stress factors and support needs during pregnancy and after birth; screening for postpartum depression and anxiety disorders; interviewing pregnant women about substance use (smoking, alcohol, drugs) and appropriate counselling. With regard to domestic violence and child welfare risks, some guidelines recommend routine screening and some recommend increased awareness of signs and symptoms by health workers. Routine screening for specific mental and behavioural disorders in children is not recommended by included guidelines; however, if there are indications and symptoms, clarification should take place and attention should be paid to signs and symptoms during preventive examinations. Conclusions The included guidelines recommend screening and/or counselling for the majority of the topics addressed. The results of the report can be used as a basis for decision-making for updating national antenatal care and screening programmes. Key messages The majority of the included evidence-based guidelines strongly recommend addressing mental health issues during pregnancy and after birth by offering screening and/or counselling. The recommendations from evidence-based guidelines can serve as a decision support for developing national antenatal and postnatal care programmes.