Table 2 Criteria for inclusion and exclusion of studies in the pregnant and postpartum review
| Â | Inclusion criteria | Exclusion criteria |
|---|---|---|
Population | Key question 1: patients during pregnancy and up to 1 year postpartum of any age Key question 1a: patients during pregnancy and up to 1 year postpartum selected for screening because they have characteristics that may suggest an elevated risk of depression* *characteristics as defined in primary studies (e.g. trauma early in life, a family history of depression) | - If > 20% of women have a recent history of depression, have a current diagnosis, or are receiving treatment for depression or other mental disorders (unless results are provided separately from the population of interest) - Women with a history of depression during pregnancy or the postpartum period - Women seeking services due to symptoms of mental disorders - Women receiving assessment or care in psychiatric or mental health settings |
Intervention | Interventions that use a single question, small sets of questions, or a screening questionnaire (validated or non-validated) with a pre-defined cut-off score to identify patients who may have depression, but who have not reported their symptoms to healthcare providers or who have otherwise not been identified as possibly depressed by healthcare providers. | Interventions that, in addition to screening, include depression care referral or treatment options that are not available to patients identified as depressed in the no screening trial arm |
Comparator | No depression screening Patients in comparator trial arms may be administered depression symptom questionnaires for the purpose of baseline or outcome assessments as long as scores are not provided to the patients or healthcare providers. | Â |
Outcomes | Mental health outcomes • Symptoms of depression (continuous or dichotomous) or diagnosis of MDD (using a validated diagnostic interview) • Health-related quality of life (validated tools) • Suicidality (suicide ideation, attempt, or completion) • False-positive screens (positive screens in the absence of depressive disorder), overdiagnosis, or overtreatment • Labelling/stigma • Harms of treatment Parenting outcomes • Relationship with partner and other supports • Reported/observed capacity to parent (attachment, responsiveness to infant, positive regard of infant/fetus) • Mother-child interactions including mutual touching, smiling, vocalizations, and impact on other children Infant outcomes • Infant health and development (i.e., developmental delay; failure to thrive) cognitive, emotional, motor and neural functioning and development • Infant responsiveness |  |
Timing | Published from database inception to the date the search is run | Â |
Study design | Randomized controlled trials (RCTs)* including cluster-controlled trials *Trials of screening in which patient eligibility is determined and then patients are enrolled prior to randomization (i.e., to screening or to no screening). Similar depression management and treatment resources are provided to patients in the screening arm of the trial who were identified as depressed as well as patients in either the screening or non-screening arms of the trial who were identified as depressed via other methods (e.g. unaided clinician diagnosis, patient report) [40] | RCTs where patient eligibility is determined, and patients are enrolled after randomization Non-RCTs, controlled before-after, interrupted times series, cohort studies, case-control studies, cross-sectional studies, case series, case reports, and other publication types (editorials, commentaries, notes, letter, opinions) |
Setting | Primary care or other non-mental health clinic settings, including specialty clinics such as obstetrical, maternal-fetal medicine, and paediatric clinics | Studies conducted in mental health or psychiatric settings |
Language | English and French | Â |