Disparities in Screening and Treatment Patterns for Depression and Anxiety During Pregnancy: An Integrative Review.
Rachel Eakley, Audrey Lyndon
PMID 39054664WHAT IT FOUND
Pregnant patients who did not speak English were most consistently missed for depression screening, and language barriers were linked with lower referral and treatment.
Use validated tools in the patient's preferred language and explain results and follow-up.
Key findings
01Pregnant patients who did not speak English were consistently less likely to be screened, and language barriers were the most frequently reported barrier to referral and treatment.
02In one retrospective health-system analysis, patients were screened at 78.4% if cared for by family medicine doctors and 64.6% by obstetrician-gynecologists, compared with 54.4% by certified nurse midwives and 54.5% by nurse practitioners.
03In a national sample, 49.6% of pregnant women with depression received treatment, compared with 53.7% of nonpregnant women.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
One researcher searched, selected and appraised the articles, so errors or omissions could have been made. The review included only United States studies, so the patterns may not apply elsewhere. Most included studies used retrospective chart, claims or survey data, with missing data and unclear timing of pregnancy versus postpartum status. Non-English speakers were often excluded from the review and from included studies, which may hide language disparities. Findings were inconsistent across studies, especially for race, ethnicity, age and education. Provider type and clinical site were not always clear, and the reasons for site differences were not described. Very few rural participants were included. Sexual orientation, gender identity and disability were rarely reported.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that screening alone will identify and treat perinatal depression. The included studies reported language barriers, uncommunicated results, lack of follow-up, and transportation and childcare barriers to treatment.