Approaches to Antenatal Assessment of Psychosocial Vulnerability Factors among Expectant Parents: A Mixed-Method Systematic Review

Introduction: Timely identification of vulnerable expectant parents during early antenatal care is crucial for providing adequate support to families in need. Antenatal psychosocial assessment programs (APAP) are increasingly recommended by health authorities. However, there is an ongoing debate regarding the most effective method— whether structured and systematic or conversational and relational approaches—can ensure sufficient, feasible, and safe APAP. Despite this debate, there is a lack of a comprehensive examination of the various approaches to APAP.
Aim & Objectives: This study aims to offer an overview of APAP methods and tools, including their characteristics and scientific background.
Methods: We conducted a mixed-method systematic review in six databases. 77/5,394 identified studies were included.
Findings: We identified 28 APAP tools and categorized them based on assessment method, item counts, psychosocial domains, evaluation approach, partner involvement, time consumption, assessing professions, and competency requirements. We identified five assessment approaches: 1) Self-reporting, 2) Face-to-face interviews, 3) Combinations of self-reporting and structured interviews, 4) Conversational approaches, 5) Combined methods involving both structured and conversational elements. Notably, 20/28 APAP tools were structured, and 78% of the included studies were related to structured tools.
Conclusion: The study reveals a significant focus on structured approaches in existing tools and literature related to APAP, with limited attention given to conversational approaches. This underscores need for further research on conversational approaches to draw appropriate conclusions on optimal implementation of APAP in maternity and family healthcare.
Implication for practice: Our findings emphasize necessity for additional research and understanding of conversational approaches in APAP to inform best practice in maternity and family healthcare.