Funding from Australian Rotary Health has supported the development and validation of a new screening tool to help professionals identify psychosocial risk during the perinatal period.

The Antenatal Risk Questionnaire-Revised (ANRQ-R) was developed by ARH Geoffrey Betts Postdoctoral Fellowship recipient Dr Nicole Reilly in partnership with Professor Marie-Paule Austin and an expert advisory group.

The ANRQ-R is a structured questionnaire that can be scored to provide an overall assessment of psychosocial risk and resilience factors in pregnant and postnatal women. It builds on the original ANRQ and includes items related to substance use and domestic violence.

“There is growing evidence that participation in perinatal depression screening programs increases referral rates and service use and is associated with more optimal emotional health outcomes for pregnant and postnatal women,” Dr Reilly said.

“This project aimed to develop and evaluate a brief measure of psychosocial risk that meets Australia’s best practice guidance as well as Medicare Benefits Schedule requirements for pregnancy and postnatal care.”

The ANRQ-R has since been evaluated in a large community sample of pregnant women attending the Royal Hospital for Women (NSW). These women completed measures, including the ANRQ-R, in their second trimester, third trimester and 3-months following birth.

Results demonstrated that the ANRQ-R is an acceptable, reliable, and valid tool that can be used to identify current, or predict future, depression or anxiety across the perinatal period.

“[The ANRQ-R] can be routinely used by clinicians to gain an insight into a woman’s psychosocial circumstances and to help guide decisions about appropriate care options,” Dr Reilly said.

Dr Reilly noted that despite significant improvements in the reach of routine mental health screening for pregnant and postnatal women in Australia, data in the last 5 years shows that perinatal mental health screening is still not yet universal.

“One-in-five women reported that they were not screened both antenatally and postnatally, as is recommended, with women who reported experiencing emotional distress among less likely to be screened during pregnancy and in the year after birth,” she said.

Another barrier to effective screening is a reluctance from mothers to disclose sensitive information before they have built a relationship with their health professional.

“Providing ongoing clinical supervision and augmenting clinician skills in terms of building trust and confidence is critical for reducing stigma and improving disclosure of mental health and psychosocial issues among perinatal women, so that health professionals can more comprehensively identify women’s needs and offer timely support.”

Dr Reilly hopes that her research can be used to evaluate key policy initiatives, support clinical best practice recommendations and drive knowledge exchange and research translation.

The following scientific articles have been published on this measure:

• The Antenatal Risk Questionnaire-Revised: Development, use and test-retest reliability in a community sample of pregnant women in Australia.
• Supporting routine psychosocial assessment in the perinatal period: The concurrent and predictive validity of the Antenatal Risk Questionnaire-Revised.
• Why do some pregnant women not fully disclose at comprehensive psychosocial assessment with their midwife?
• Disclosure of sensitive material at routine antenatal psychosocial assessment: The role of psychosocial risk and mode of assessment

Media contact: Jessica Cooper – [email protected]

First published 19th July 2022. Updated 11th August 2022.