Abstract
As noted in the Perinatal Mental Health and Substance Use Disorders White Paper (American Psychological Association and Centers for Disease Control, 2023), the treatment of perinatal pain may improve health-related quality of life and reduce perinatal depression. However, little is known about the co-occurrence of these conditions during the perinatal period. A synthesis of perinatal pain and depression symptoms is needed to identify knowledge gaps that may affect clinical outcomes. The purpose of this systematic review is to describe the (a) prevalence, (b) screening, and (c) treatment of co-occurring perinatal pain and depression symptoms. Using the PRISMA checklist, comprehensive strategies were used to find articles from inception (1987) to June 2023 in PubMed, CINAHL, Scopus, and PsycINFO/PyscARTICLES. Sixty-two studies (of which 34 were longitudinal studies, n= 95,194 (53.5%), 22 were cross-sectional studies, n= 22,320 (35.5%)) specifically evaluated both perinatal pain and depression symptoms. Co-occurrence prevalence rates ranged from 2% to 38%, depending upon the type of pain and the trimester or time postpartum the pain occurred. Pain was most frequently screened by patient self-report (24.2%) or the visual analog scale (24.2%). Depression was most frequently screened using the Edinburgh Postnatal Depression Scale (54.8%). Only eight articles addressed treatments such as medications, exercise, and education, finding that depression symptoms decreased when perinatal pain was treated. Despite a growing awareness of the relationship between perinatal pain and depressive symptoms, further work is needed to conclusively link types and timing of pain to depressive symptoms, standardize screening measures, and evaluate treatments.