The US Preventive Services Task Force has obtained convincing evidence that behavioral health interventions such as the Mothers and Babies program and the Reach Out, Stand Strong, Essentials for New Mothers program are effective in the preventing perinatal depression.
An evidence-to-practice gap has been observed in the field of obstetrics, with evidence strongly supporting universal mental health screening although population-level rates of screening nonetheless remain low
The researchers evaluated the current literature on the association between pregnancy complications and perinatal health mental health conditions. Findings from their analysis were published recently in the American Journal of Obstetrics & Gynecology Maternal-Fetal Medicine
In their review, the investigators provided recommendations on mental health care needed among high-risk patients who experience pregnancy complications. Such pregnancy-related complications can include fetal and neonatal alloimmune thrombocytopenia (FNAIT) and hemolytic disease of the fetus and newborn (HDFN)
Among pregnant patients who experience complications, perinatal mental health issues can range from depression to anxiety to posttraumatic stress disorder. In spite of the increased disease burden, however, limited research is available on how to support mental health among those who experience pregnancy-associated complications, who have been described as “a unique population with unmet needs.”
An important aspect to the promotion of perinatal mental health involves “early intervention to prevent mental health conditions.” In terms of preventing perinatal depression, 2 evidence-based programs that have received widespread endorsement include the cognitive behavioral therapy-based Mothers and Babies (MB) program and the interpersonal psychotherapy-based Reach Out, Stand Strong, Essentials for New Mothers (ROSE) program
Results of multiple clinical trials have revealed that MB has the dual ability to reduce symptoms of depression and prevent the development of new cases of postpartum depression. “The MB intervention is based on principles of cognitive behavioral therapy, attachment therapy, and psychoeducation.”
The highly structured ROSE program, which can be delivered by individuals with a variety of backgrounds, typically includes 4 or 8 group prenatal sessions and 1 postnatal booster session. Topics involve postpartum depression, self-care, management of the transition to motherhood, goal-setting, and assertiveness
The researchers have recommended numerous ways in which obstetric clinicians can expand their ability to provide appropriate mental health care for those high-risk individuals in whom pregnancy complications are anticipated to occur
Included among these proposed strategies are medical education, enhanced screening for perinatal depression, and collaborative care “that integrates screening and tailored mental health support into primary care.” The collaborative care model comprises 3 specific changes to the delivery of mental health care:
- Care managers provide brief behavioral interventions and enable care coordination.
- All enrolled patients are entered into a patient registry in which serial mental health screens are performed and collected to help guide treatment decisions.
- Stepped care plans are developed during weekly multidisciplinary team meetings that include a supervising psychiatrist.
“Multiple studies have shown that individuals who experience pregnancy complications are more likely to report symptoms of depression and anxiety, as compared [with] those with uncomplicated pregnancies,” the authors wrote
“Mental health is an essential component of maternal health, and it must be addressed in a systematic, evidence-based manner in order to optimize maternal care and improve outcomes for all patients, especially those high-risk patients experiencing pregnancy complications,” they concluded
This article originally appeared on Rare Disease Advisor
Goulding AN, Fletcher TL, Miller ES. Perinatal mental health screening and care among those with pregnancy complications. Am J Obstet Gynecol MFM. Published online May 30, 2026. doi:10.016/j.ajogmf.2026.102006
