Screening instruments for antenatal and postpartum mental health disorders in migrant women: a systematic review

Maternal mental health disorders are prevalent among migrant women. Due to the association of these disorders with adverse pregnancy outcomes, early recognition, and referral are important. This review aims to provide an overview of the literature on mental health screening for migrant women during pregnancy and the postpartum period.

We systematically searched PubMed, EMBASE, and PsycINFO, covering publications before July 15th, 2024. Database searches were supplemented by a grey literature search, which included a systematic Google and Google Scholar search, hand searching of reference lists, and citation searches. Quantitative, qualitative, and mixed-method studies published in any language were included if they evaluated or validated screening methods for maternal mental health disorders in first-generation migrants. Screening for eligibility, data extraction, and quality appraisal were conducted by two independent researchers. Results were summarized narratively.

Among the 3035 records screened, 30 articles met the inclusion criteria. Our findings indicate that health care providers and migrant women recognize a substantial need for maternal mental health screening, especially for depression, and in a lesser quantity for anxiety and PTSD. We describe a range of barriers and facilitators that impact the quality and feasibility of mental health screening. Research on available screening instruments in migrant populations reports reasonable accuracy, reliability, and validity. However, qualitative evaluations question the screening instruments' cultural appropriateness and translatability.

There is an urgent need for the development and implementation of maternal mental health screening programs tailored to pregnant or postpartum migrants. Further research is essential to enhance the effectiveness and cultural sensitivity of these screening programs.