How can we improve care for pregnant and post-partum migrants?

We will discuss “Migration and perinatal mental health in women from low- and middle-income countries: a systematic review and meta-analysis” by Fellmeth and co-workers from 28 September 2016 for 7 days.

*This paper will be made free-to-view  approximately 10 days before the start of #BlueJC. The linked mini-commentary on this paper can also be found via this research report.

We are now on LinkedIn too: http://linkd.in/1BVrpad (simply ask to join)!

Start date: 28 September 2016 (the discussion will continue for 7 days between 28 September 2016 – 5 October 2016)

First hosted discussion session(s) on Twitter starts at: GMT+1 (British Summer Time) 8pm (using hashtag #BlueJC)

Host: @BlueJCHost

Platforms: Twitter, Facebook and LinkedIn 

BJOG_BlueJC_160x600WebBanner_Mar15_(reoriented)_3The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (click on the “supporting information” tab).

The discussion points are attached below (quoted from the published Journal Club guide)

Scenario

A pregnant woman came to see her midwife for the first time with her two young children after arriving from Syria 2 weeks ago as asylum seekers, with no other relatives in the UK. She spoke poor English and you communicated with her via an interpreter. She had 2 normal vaginal births and no other significant medical history. Symphysis fundal height was 22cm and fetal heart sounds were heard.

What additional questions would you ask this woman? How would you manage this pregnancy?

Description of research

Participants Pregnant and post-partum migrants, including refugees & asylum-seekers, from low-and-middle income countries (LMICs)
Intervention Prevalence, risk factor and intervention studies
Comparison Non-migrants
Outcomes Prevalence and risk factors for depressive disorders, and treatment given
Study design Systematic review and meta-analysis
Authors’ conclusion Overall, 3 in 10 pregnant and post-partum migrant had depressive disorders, and they are associated with prior history of depressive disorder and poor social support.

Discussion Points

  • Which additional factors would you consider when you counsel the woman in the above scenario?
  • How did the authors assess heterogeneity and address its problem in this systematic review (see suggested reading)?
  • What are the strengths and weaknesses of this meta-analysis (see suggested reading)?
  • How does the prevalence of perinatal mental disorders in your practice compare to that reported in this study?
  • What were the most significant risk factors for perinatal depression in migrants?
  • What were the gaps identified in the evidence on perinatal mental health in migrants?
  • How can health professionals minimise the negative impact of perinatal mental disorders in migrants and their families?
  • How may the results of this study influence your daily practice?

Suggested reading

  • Scottish Intercollegiate Guidelines Network. Critical Appraisal: notes and checklists. Methodology checklist 1: Systematic reviews and meta-analyses. http://www.sign.ac.uk/methodology/checklists.html (Last access 20 July 2016)
  • The Cochrane Collaboration. Part 2 Section 9.5: Heterogeneity. Cochrane Handbook for Systematic Reviews of Interventions. 2011. Version 5.1.0. Available from http://handbook.cochrane.org/.

 

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.