Screening, diagnosing, and managing perinatal depression: Review of SIX national guidelines

Perinatal depression is a common and serious mental health condition affecting up to 20% of pregnant and postpartum individuals worldwide. It is characterized by persistent low mood, anhedonia, and functional impairment, with potential consequences for maternal well-being, obstetric outcomes, and infant development. Management is challenging for obstetricians, as treatment decisions must balance maternal mental health needs with fetal and neonatal safety, amid varying guideline recommendations and limited consensus on optimal screening and pharmacologic strategies. The American College of Obstetricians and Gynecologists, the National Institute for Health and Care Excellence, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Scottish Intercollegiate Guidelines Network, the Centre of Perinatal Excellence and the Canadian Network for Mood and Anxiety Treatment have all released guidelines to address the risks, diagnosis and management of perinatal depression. We performed a descriptive review of these guidelines along with a literature search to address conflicting recommendations and highlight new evidence. The variations in the guidelines reflect the heterogeneity of literature and the challenges of diagnosis and managing perinatal depression.