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Feasibility of universal screening for postpartum mood and anxiety disorders among caregivers of infants hospitalized in NICUs: a systematic review

Journal of Perinatology volume 41, pages 1811–1824 (2021)Cite this article

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Abstract

This systematic review evaluated the feasibility of implementing universal screening programs for postpartum mood and anxiety disorder (PMAD) among caregivers of infants hospitalized in the neonatal intensive care unit (NICU). Four moderate quality post-implementation cohort studies satisfied inclusion criteria (n = 2752 total participants). All studies included mothers; one study included fathers or partners. Screening included measures of depression and post-traumatic stress. Screening rates ranged from 48.5% to 96.2%. The incidence of depression in mothers ranged from 18% to 43.3% and was 9.5% in fathers. Common facilitators included engaging multidisciplinary staff in program development and implementation, partnering with program champions, and incorporating screening into routine clinical practice. Referral to mental health treatment was the most significant barrier. This systematic review suggests that universal PMAD screening in NICUs may be feasible. Further research comparing a wider range of PMAD screening tools and protocols is critical to address these prevalent conditions with significant consequences for parents and infants.

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Fig. 1: PRISMA Diagram.

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Acknowledgements

Special thanks to UCSF research librarian, Evans Whitaker, MD, and our research team supervisor, Claudine Catledge, MA.

Funding

LF received support for this work from the University of California, San Francisco, California Preterm Birth Initiative, funded by Marc and Lynne Benioff. LH received support for this work from the National Institute of Nursing Research Biobehavioral Research Training in Symptom Science Grant (T32NR016920). SM, SB, BF, and CM received no funding for this work. Outside of this work, CM is supported by several grants including the National Institutes of Mental Health (R01MH112420), Genentech, the Doris Duke Charitable Foundation (Grant 2015211), and the California Health Care Foundation. She is a founding member of TIME’S UP Healthcare, but receives no financial compensation from that organization. In 2019, she has received one-time speaking honoraria from Uncommon Bold.

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Author notes

  1. These authors jointly supervised this work: Linda S. Franck, Christina Mangurian

Authors and Affiliations

  1. School of Medicine, University of California, San Francisco, CA, USA

    Snehal Murthy

  2. Benioff Children’s Hospital Oakland, University of California, San Francisco, CA, USA

    Laurel Haeusslein

  3. Department of Medicine, University of California, San Francisco, CA, USA

    Stephen Bent

  4. Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA

    Elizabeth Fitelson

  5. School of Nursing, University of California, San Francisco, CA, USA

    Linda S. Franck

  6. Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA

    Christina Mangurian

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  1. Snehal Murthy
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  2. Laurel Haeusslein
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  4. Elizabeth Fitelson
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  5. Linda S. Franck
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  6. Christina Mangurian
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Contributions

All authors contributed to the design and methods for the project and provided oversight. SM and LH conducted the searches, quality assessments and data abstraction. SB provided insight into systematic review methodology. BF provided expertise in peripartum mood and anxiety disorders. CM/LF oversaw the entire project, provided supervision to SM/LH, and were actively involved in writing and revising the paper. All authors contributed to the interpretation of the findings and paper preparation. All authors read and approved the final paper.

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Correspondence to Christina Mangurian.

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Murthy, S., Haeusslein, L., Bent, S. et al. Feasibility of universal screening for postpartum mood and anxiety disorders among caregivers of infants hospitalized in NICUs: a systematic review. J Perinatol 41, 1811–1824 (2021). https://doi.org/10.1038/s41372-021-01005-w

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