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Economic evaluation of screening, treatment, and prevention interventions for perinatal mood and anxiety disorders: a
Sabrina Alam1, Brian Christman2, Emma McNeill3
1Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, United States.
Insights
Interventions for perinatal mood and anxiety disorders (PMADs) are largely cost-effective. Integrating these interventions into perinatal care requires evidence-based policy and payment models for sustainable uptake.
Area of Science:
- Perinatal mental health
- Health economics
- Evidence-based interventions
Background:
- Perinatal mood and anxiety disorders (PMADs) affect many individuals during pregnancy and postpartum.
- Economic evaluations are crucial for understanding the value of PMAD interventions.
- This review synthesizes the cost-effectiveness of various PMAD interventions.
Conclusions:
- Findings strongly support integrating PMAD interventions into routine perinatal care.
- Development of evidence-based policy and payment models is essential for widespread and sustainable implementation.
- Future research should focus on standardizing economic evaluation methods, employing longer-term modeling, and including diverse populations.
Objective:
This systematic review synthesized evidence on the cost-effectiveness and economic favorability of interventions for the detection, treatment, and prevention of perinatal mood and anxiety disorders (PMADs).
Methods:
This protocol is registered on PROSPERO (CRD42024528777). PubMed, EMBASE, Web of Science, EconLit, Scopus, PsycINFO, and the National Health Service economic evaluation databases were searched from inception through April 2025. Intervention studies reporting quality-adjusted life years, incremental cost-effectiveness ratios, or equivalent cost analyses during pregnancy or up to one year postpartum were included. Risk of bias was assessed using the Consensus on Health Economics Criteria and Bias in Economic Evaluation checklists. Data were synthesized by study design, intervention type, and economic perspective.
Findings:
The search identified 3863 records; 1820 deduplicated titles and abstracts, and 75 full texts were assessed for eligibility. Thirty-seven studies were included (n = 218,525 participants). Thirty-two (86.5 %) interventions were cost-effective or economically favorable, including prevention-only (28.1 %), treatment-only (34.3 %), screening-only (18.7 %), and screening plus treatment and/or prevention (18.7 %). Cost-effective evaluations were primarily from the healthcare system (46.8 %) or payer (25 %) perspectives. Twenty-two (68.7 %) cost-effective interventions included time horizons of one year or greater. Five of six (83.3 %) non-cost-effective interventions included time horizons of less than one year. Studies were heterogeneous in design, population, and intervention types.
Interpretation:
Findings support the integration of PMAD interventions into perinatal clinical care. Evidence-based policy and payment models are needed for scaling sustainable uptake. Research priorities include standardization in economic evaluation methods, longer-term modeling, and inclusion of diverse populations.
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