JMIR Publications

ABSTRACT

Background:

Identifying mental health disorders in women of migrant and refugee background in pregnancy provides an opportunity for intervention that can benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is the leading cause of maternal morbidity post-partum. Routine screening of perinatal mental health is recommended to improve identification of depression and anxiety and facilitate early management. However, screening is poorly implemented in routine practice. This study is the first to investigate the implementation of routine screening for perinatal mental health in a maternity setting designed for women of refugee background. The study will determine whether symptoms of depression and anxiety are more likely to be detected using the screening program compared to routine care and evaluate the screening program’s feasibility and acceptability to women and health providers.

Objective:

1. To assess if women of refugee background are more likely to screen risk positive for depression and anxiety on the EPDS than women of non-refugee background? 2. To assess if screening in pregnancy using the EPDS enable better detection of symptoms of depression and anxiety in women of refugee background compared to current routine care? 3. To determine if screening is acceptable to women 4. To identify what factors contribute to the screening being perceived as a feasible part of routine practice by maternity health care providers (HCPs)?

Methods:

This study uses an internationally recommended screening measure, the Edinburgh Postnatal Depression Scale (EPDS) and a locally developed psychosocial questionnaire, administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages of women attending the clinic and are administered via an electronic platform (iCOPE). This enables automatic calculation of the EPDS score and a report for the health provider and woman. A total of 120 women of refugee background and 155 non-refugee women have been recruited to evaluate the screening program’s ability to detect depression and anxiety symptoms, and will be compared to 34 women of refugee background receiving routine care. A sub-sample of women will participate in a qualitative assessment of the screening program’s acceptability and feasibility. Health clinic staff have been recruited to evaluate integration of screening into maternity care.

Results:

No results are available at this time

Conclusions:

It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New knowledge will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for women of refugee background. Clinical Trial: Not a trial - a cohort study