Cost‐effectiveness of mental health interventions during and after pregnancy: A systematic review

Abstract

Background Mental health problems during and after pregnancy such as depression, anxiety, post‐traumatic stress disorder (PTSD), or addiction are common and can have lifelong implications for both parents and offspring. This review investigates the cost‐effectiveness of interventions tackling these problems, assesses the methodological quality of included studies, and indicates suggestions for further research. Methods Thirteen databases were searched for economic evaluations of interventions related to antenatal, perinatal, and postnatal mental health conditions, published between 2000 and September 2021, in high‐income countries. Results Thirty‐nine studies met all inclusion criteria. Interventions considered were screening programs, pharmacological treatments, and various forms of psychosocial and psychological support. Six studies reported that the intervention was cost‐saving. Eighteen were cost‐effective and seven likely to be cost‐effective. Only six studies included health outcomes for the child; one study considered paternal health. The time horizon for which costs and consequences were considered was for most evaluations limited to 1 year (n = 18) or 2 years (n = 11) postpartum. Conclusions Given the importance of the subject, a relatively low number of studies have investigated the cost‐effectiveness of interventions tackling mental health problems during and after pregnancy. The scant evidence available suggests good overall value for money. Likely, cost‐effectiveness is underestimated as costly long‐term consequences on offspring are systematically excluded. No evidence was found for several frequently occurring conditions. Further research is required to obtain reliable, long‐term effectiveness data and to address the methodological challenges related to measuring all relevant health outcomes for all parties affected.

Association between trajectories of maternal depressive symptoms and length of hospital stay, hospitalization costs, and adverse maternal and infantile outcomes: A longitudinal observational study

“…A recent systematic review identified that a relatively low number of studies have investigated the cost-effectiveness of interventions tackling mental health problems during and after pregnancy (Verbeke, et al, 2022). The healthcare utilization and costs associated with perinatal depressive symptoms have been found to be significant (Bauer et al, 2016(Bauer et al, , 2022Luca et al, 2020;Pollack et al, 2022).…”