Postpartum care indications and methodological quality:a systematic review of guidelines

Yang, Ming; Yue, Wei; Han, Xin‐Rui; Hu, Chunhong; Sun, Xiaoning; Luo, Jianghe

doi:10.1007/s10389-021-01629-4

Cited by 11 publications

(12 citation statements)

References 26 publications

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“…Domain scores were calculated by summing up all the scores of the individual items in a domain and by scaling the total as a percentage of the maximum possible score for that domain 56 . To make the scores more accessible to readers and enable comparison, the AGREE II outcomes are reported categorically using the ve-point Likert scale described by Yang et al 47 : excellent (> 80%), good (> 60-80%), average (> 40-60%), fair (> 20-40%) and poor (≤ 20%). All items on the AGREE-II tool were equally weighted but might not have been of equal importance in terms of the richness of guideline content and recommendations.…”

Section: Quality Assessmentmentioning

confidence: 99%

A systematic review of clinical psychological guidance for perinatal mental health

O’Brien

Gregg

Wittkowski

2023

Preprint

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Background Guidelines on psychological and/or psychosocial assessment and intervention in the perinatal period can provide beneficial practice guidance for healthcare professions to reduce maternal distress and potential mortality. As little is known about the similarities in recommendations across guidelines, which could impact the quality of therapeutic intervention women receive, this systematic review was conducted to draw out the consistent guidance for perinatal psychological and/or psychosocial therapeutic input. Method Eight literature and two guideline databases were searched alongside guideline development institutions, and organisations of maternity or perinatal mental health care. All relevant guidance was searched for and extracted before guideline quality was assessed using the AGREE-II instrument. Included guidelines had a primary or secondary focus on psychological assessment and therapeutic intervention for perinatal mental health difficulties. Using a narrative synthesis approach, recommendation consistencies and inconsistencies were outlined. Results From the 92 records screened, seven guidelines met the inclusion criteria. Only two guidelines were rated high (> 80%) across all assessed domains, with the other guidelines scoring between poor and excellent across domains. Highest rated domains across all seven guidelines were clarity of presentation (75%) and scope and purpose (70%). Recommendations for structured psychological assessment and intervention were most commonly reported in the guidelines; however, the level of detail and depth of information varied across guidelines. Whilst assessment and intervention recommendations for mother-infant dyad and partners were considered, research into working therapeutically with these client groups in perinatal mental health services is only just emerging. Hence, guideline recommendations for working with the mother-infant dyad and partners were based on consensus of expert opinion. Conclusion Perinatal mental health guidelines were consistent in scope but showed considerable variability in quality and depth of recommendations, which could have implications for standards of clinical practice. However, there is still a need to improve the evidence underpinning recommendations in perinatal mental health guidelines to advance the implementation of psychological and/or psychosocial interventions. High quality interventions in the perinatal period could improve outcomes for women and their families.

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Section: Quality Assessmentmentioning

confidence: 99%

A systematic review of clinical psychological guidance for perinatal mental health

O’Brien

Gregg

Wittkowski

2023

Preprint

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“…16 Two systematic reviews of guidelines for the management of specific aspects of routine postpartum care and complications arising in the postpartum period can help providers identify current best practices in postpartum care. 15,17 Both reviews highlight the need for additional research in areas where practice guidance is based on case reports or expert opinion. Clinical guidelines, however, typically focus on specific organs or organ systems and on postpartum disorders and fail to account for key functional and quality of life domains in patients' experiences.…”

Section: Wpc In the Fourth Trimestermentioning

confidence: 99%

“…This feeling is likely compounded by the fact that many common clinical postpartum care practices, such as the management of postpartum pain, are not evidence-based because of a lack of research to guide practice 16. Two systematic reviews of guidelines for the management of specific aspects of routine postpartum care and complications arising in the postpartum period can help providers identify current best practices in postpartum care 15,17. Both reviews highlight the need for additional research in areas where practice guidance is based on case reports or expert opinion.…”

Section: The Obstetric Care Provider As Primary Care Provider In the ...mentioning

confidence: 99%

Operationalizing Whole-Person Postpartum Care: Health Care Provider-Level Strategies

Fahey

2022

Clinical Obstetrics &Amp; Gynecology

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Postpartum mothers report feeling unsupported and unprepared by their health care providers to meet the challenges of the postpartum period. This gap perpetuates a cycle of disappointment with and disengagement from postpartum care services. The need to revamp postpartum care has been recognized at the population level but implementing changes at the health care provider level is challenging without practical guidance. The needs of new mothers are broad in scope and variable between individuals, requiring a whole-person care approach that is comprehensive yet nimble. Presented here are providerlevel strategies to promote care that both elicits and is responsive to the unique care goals of this population.

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“…Confronted with the rapid increase in the number of infections and the uncertainty of the outcome, people in the whole world are facing varying degrees of psychological pressure. The fear of the COVID-19 infection and the strict isolation measures have produced a negative impact on the mental health of people ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Study characteristical and regional influences on postpartum depression before vs. during the COVID-19 pandemic: A systematic review and meta-analysis

Zhang

Wang²,

Zuo³

et al. 2023

Front. Public Health

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BackgroundWhile the public is under serious pressure from the coronavirus disease 2019 (COVID-19), the final impact and possible contributing factors to postpartum depression symptoms (PPDS) remain unknown. Therefore, a meta-analysis to investigate the association between PPDS and the COVID-19 pandemic was carried out by comparing the data between pre-pandemic and post-pandemic timeframes and exploring the influencing factors.MethodsThis systematic review was prospectively registered and recorded in a study protocol (Prospero CRD42022336820, http://www.crd.york.ac.uk/PROSPERO). A comprehensive search of PubMed, Embase, Web of Science, CINALH, Cochrane and Scopus was cmpleted on June 6, 2022. Studies that compared the prevalence of PPD before and during the COVID-19 pandemic period were included.ResultsOf 1766 citations identified, 22 studies were included with 15,098 participates before the COVID-19 pandemic and 11,836 participants during the COVID-19 pandemic. Overall, the analysis showed that the epidemic crisis was associated with an increased prevalence of PPDS (OR: 0.81 [0.68, 0.95], P = 0.009, I2 = 59%). Subgroup analysis was conducted according to the study characteristics and regions. Within the study characteristics classification, results showed an obvious increase in the prevalence of PPDS during the COVID-19 pandemic if PPDS cutoff was defined as Edinburgh postpartum depression score (EPDS) ≥13 points (OR: 0.72 [0.52, 0.98], P = 0.03, I2 = 67%) and an increased prevalence in follow-ups that happened after 2 weeks (≥ 2 weeks postpartum) (OR: 0.81 [0.68, 0.97], P = 0.02, I2 = 43%). Selected studies that were high-quality (OR: 0.79 [0.64, 0.97], P = 0.02, I2 = 56%) demonstrated an increased prevalence of PPDS during the COVID-19 pandemic period. Sorting by regional factors, studies conducted in Asia (OR: 0.81 [0.70, 0.93], P = 0.003, I2 = 0%) showed an increase of PPDS prevalence rates during the COVID-19 period, while studies conducted in Europe (OR: 0.82 [0.59, 1.13], P = 0.23, I2 = 71%) and North America (OR: 0.66 [0.42, 1.02], P = 0.06, I2 = 65%) showed no significant difference. All studies conducted in the developed (OR: 0.79 [0.64, 0.98], P = 0.03, I2 = 65%) and developing countries (OR: 0.81 [0.69, 0.94], P = 0.007, I2 = 0%) showed an increase of PPDS during the COVID-19 period.ConclusionsThe COVID-19 pandemic is associated with an increased prevalence of PPDS, especially after long-term follow-up and among the group with a high possibility of depression. The negative influence from the pandemic, causing more PPDS was significant in studies from Asia.

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Postpartum care indications and methodological quality:a systematic review of guidelines

Cited by 11 publications

References 26 publications

A systematic review of clinical psychological guidance for perinatal mental health

A systematic review of clinical psychological guidance for perinatal mental health

Operationalizing Whole-Person Postpartum Care: Health Care Provider-Level Strategies

Study characteristical and regional influences on postpartum depression before vs. during the COVID-19 pandemic: A systematic review and meta-analysis

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