Title

Supporting routine psychosocial assessment in the perinatal period: The concurrent and predictive validity of the Antenatal Risk Questionnaire-Revised

Publication Name

Women and Birth

Abstract

Background: Australian clinical practice guidelines support comprehensive psychosocial assessment as a routine component of maternity care. Aim: To examine the concurrent and predictive validity of the Antenatal Risk Questionnaire-Revised (ANRQ-R) when used across the perinatal period. Methods: Women completed the ANRQ-R and a diagnostic reference standard (SAGE-SR) in the second and third trimesters and at 3-months postpartum. ANRQ-R test performance for cut-off scores at each time-point was assessed using Receiver Operator Characteristic (ROC) analysis. Findings: Overall sample sizes were N = 1166 (second trimester), N = 957 (third trimester) and N = 796 (3-month postpartum). 6.5%, 5.6% and 6.2% of women met SAGE-SR criteria for any depressive or anxiety disorder at these time-points (‘cases’), respectively. ROC analysis yielded acceptable areas under the curve (AUC) when the ANRQ-R was used to detect current (AUC = 0.789−0.798) or predict future (AUC = 0.705−0.789) depression or anxiety. Using an example cut-off score of 18 or more, the ANRQ-R correctly classified 72–76% of concurrent ‘cases’ and ‘non-cases’ (sensitivity = 0.70−0.74, specificity = 0.72−0.76) and correctly predicted 74–78% of postnatal ‘cases’ and ‘non-cases’ (sensitivity = 0.52−0.72, specificity = 0.75−0.79). Completion of the ANRQ-R earlier in pregnancy yielded greater positive likelihood ratios for predicting depression or anxiety at 3-months postpartum (cut-off ≥18: second trimester = 3.8; third trimester = 2.2). Conclusion: The ANRQ-R is a structured psychosocial assessment questionnaire that can be scored to provide an overall measure of psychosocial risk. Cut-off scores need not be uniform across settings. Such decisions should be guided by factors including diagnostic prevalence rates, local needs and resource availability.

Open Access Status

This publication may be available as open access

Funding Sponsor

St John of God Health Care

Share

COinS
 

Link to publisher version (DOI)

http://dx.doi.org/10.1016/j.wombi.2021.04.003