【中图分类号】R714.46【文献标识码】A DOI：10.12114/j.issn.1007-9572.2024.0290

Application and Evaluation of the Mobile Platform for Perinatal Depression Screening and Intervention

WUDadongl，²，LIUHuimin’，ZHANG Jiayi³，LIU Siyuan³，ZHAO Guanglin’，JIN Shuyan’，JIANG Leil* 1.Shenzhen Maternityand Child Healthcare Hospital，Southern Medical University，Shenzhen518028，China 2.Shenzhen Key Laboratory ofMaternal and Child Health and Diseases，Shenzhen518028，China 3.SchoolofHealthManagement，Southern Medical University，Guangzhou5io515，China *Corresponding author：JIANG Lei，Chief physician；E-mail：jianglei652006@126.com

【Abstract】BackgroundPerinatal depresson，which affcts both maternal andchild health，isasignificant public healthissue thatrequiresurgentandeffective management.Since2O21，Shenzhen hasbeen promoting city-wideperinatal depressionscreningand interventionusingamobilehealthcareplatform.ObjectiveThisstudyutilisesroutinedatafromthe Shenzhenperinatal depressionscreeningand interventionprogramme toassess theimpactof themobileplatformonprogramme implementationandidentifythe mostprominent implementation botlenecks.MethodsThis retrospective studyincluded pregnantandpostpartum womenwhodelivered inoneof Shenzhen's82midwiferyinstitutionsacross 1Odistricts between June 2020andMayO2.Eligibleparticipantsweredividedinto twogroups：theroutineservicegroup（deliveredbetweenJune2020 and May2021）and the mobile platform group（deliveredbetweenJune2O21and May 2O22）.Depressionscreening rates，screning positiverates，referalrates，and interventionratesduringearlypregnancy，mid-pregnancy，latepregnancy，and postpartum wereobserve.ResultsAtotal of311719 pregnant and postpartum women were included in the study，of which 166 832 were in the routine service group and144 887 in the mobile platform group.Screning rates，referal rates，and interventionrates in allstages of pregnancyandpostpartum were significantlyhigher inthe mobile platform group than in the routine service group （ Plt;0.05 ）. Screening positive rates in early and mid-pregnancy were higher in the mobile platform group （ Plt;0.05 ），while rates in late pregnancy and postpartum were lower than in the routine service group （ Plt;0.05 ） . Conclusion The mobile platformofersan effctive tool forroutine perinatal depression management.However，thelow intervention rate among screning-positive womenrepresents the most prominent implementation botleneck.Futureresearch should focus onoptimising platform functionality，identifying the most efectivecombinationof intervention measures，enhancing health education，and developing innovative，sustainable，and widely applicable implementation strategies.

【Key words】Perinatal depression；Screening；Intervention；Mobile platform；Eectiveness

围产期抑郁是指妇女在妊娠期间及分娩后1年内出现的抑郁障碍，根据发生时段可分为产前抑郁和产后抑郁[1]。围产期抑郁通常表现为孕产妇持续性的情绪低落、兴趣丧失、睡眠和/或进食障碍等症状，严重时可能导致自杀倾向。而对子代而言，围产期抑郁可能增加早产风险，影响婴幼儿的发育，并对其认知、社交和情感发展产生长期的不利影响。此外，孕产妇的抑郁症状还可能破坏亲密关系，引发家庭矛盾甚至家庭结构破碎，同时加重公共卫生和社会保障系统的负担[2-5]根据NISAR等 ^[6]Meta 分析结果，我国大陆地区围产期抑郁的合并患病率为 16.3% ，其中产前抑郁为 19.7% ，产后抑郁为 14.8% ，这些比率处于中低收入国家水平（ 19%～25% ）和高收入国家水平（ 7%～15% ）之间。鉴于围产期抑郁作为影响妇女儿童健康的重要公共卫生问题，对其有效管理迫在眉睫。

普遍筛查、尽早干预已被证实是能有效改善围产期抑郁的措施[7-8]。随着信息技术的发展，使用\"互联网 + 心理干预”模式已成为围产期抑郁管理的趋势。国内外已有多项研究证明了该模式的有效性[9-12]。然而，现有研究大多样本量较小，且主要关注孕晚期和产后阶段，尚缺乏大样本量下覆盖孕产期全程的研究证据。深圳市自2013年起由地方财政出资在全市范围内开展产后抑郁筛查与干预工作［13］，2019 年进一步启动围产期抑郁筛查与干预项目[14]。该项目由产科医务人员和社区产后访视人员在常规孕检和产后访视流程中对所有孕产妇开展抑郁筛查，并对筛查结果呈阳性的妇女进行分级转诊和随访管理。……