Presentation (CTI)

OBJECTIVES: Perinatal depression is a common complication among pregnant women , leading to significant burdens, particularly in under-resourced rural areas of western China. Early identification and control can be achieved through appropriate psychological interventions. This study aims to evaluate different screening and intervention strategies for perinatal depression in rural China from a societal perspective, providing evidence to inform decision-making in resource-limited settings.
METHODS: Sixteen intervention strategies were designed across three dimensions: timing of screening, screening frequency, and type of intervention provided to women who screened positive. A Markov decision analysis model was developed using TreeAge Pro to simulate a cohort of 100,000 rural Chinese women from early pregnancy through one year postpartum, capturing health outcomes and healthcare costs associated with different screening strategies. Cost-effectiveness was evaluated by estimating incremental cost-effectiveness ratios (ICERs). One-way sensitivity analyses and probabilistic sensitivity analyses were conducted to assess the robustness of the model and results.
RESULTS: Compared with no screening, all intervention strategies generated greater gains in healthy life-years and are cost-effectiveness. Specifically, strategy which consisted of one screening during the first, second, and third trimesters and one within 42 days postpartum, combined with group psychological counseling, demonstrated the highest cost-effectiveness. This strategy yielded an ICER of -12,269.96 RMB per healthy life-year, indicating a cost saving of 12,269.96 RMB for each additional healthy life-year. One-way and probabilistic sensitivity analyses confirmed the robustness of the model results.
CONCLUSIONS: For resource-limited settings, multiple depression screenings combined with group counseling constitute the most cost-effective strategy for perinatal depression prevention and management, and should therefore be prioritized in policy-making.