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Table 4 Screening programmes compared to care as usual for postpartum depression?

From: Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence

Patient or population: Pregnant women and new mothers with symptoms of depression or anxiety

Intervention: screening programmes

Comparison: care as usual

Outcome

№ of participants (studies)

Relative effect (95% CI)

Anticipated absolute effects (95% CI)

Certainty

What happens

  

Difference

Rates of depression assessed with: Psychometric scales

№ of participants: 9009 (10 RCTs)

OR 0.55

(0.45 to 0.66)

17.5%

10.4%

(8.7 to 12.3)

7.0% fewer

(8.8 fewer to 5.2 fewer)

MODERATE a

Screening programmes likely reduces rates of depression slightly.

Severity of Anxiety symptoms assessed with: Psychometric scales

№ of participants: 3654 (3 RCTs)

SMD 0.18 SD lower

(0.25 lower to 0.12 lower)

HIGH

Screening programmes reduces severity of Anxiety symptoms slightly.

Treatment seeking

№ of participants: 1082 (3 RCTs)

OR 3.74

(2.14 to 6.52)

17.4%

44.0%

(31 to 57.8)

26.6% more

(13.7 more to 40.4 more)

MODERATE b

Screening programmes likely results in a large increase in treatment seeking.

Parental distress assessed with: Psychometric scales

№ of participants: 2336 (5 RCTs)

SMD 0.27 SD lower

(0.39 lower to 0.15 lower)

MODERATE c

Screening programmes likely reduces parental distress slightly.

Quality of life assessed with: Psychometric scales

№ of participants: 5157 (4 RCTs)

SMD 0.2 SD higher

(0.14 higher to 0.27 higher)

HIGH

Screening programmes increases quality of life slightly.

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; OR: Odds ratio; SMD: Standardised mean difference

GRADE Working Group grades of evidence

High quality: We are very confident that the true effect lies close to that of the estimate of the effect

Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different

Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect

Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

  1. Explanations
  2. a. Three out ten studies were rated as having a overall low risk of bias. Meta-regression did not reveal any significant association of scores on risk of bias scale with the pooled effect size
  3. b. Two out of three studies had an overall higher risk of bias. Subgroup analysis could not be conducted to ascertain association between risk of bias scores and effect size
  4. c. Egger’s regression statistic revealed significant publication bias