Symposia
Women's Health
Samantha N. Hellberg, M.A.
Graduate student
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Jonathan Abramowitz, Ph.D.
Professor of Psychology
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Background: The perinatal period is a unique context during which biopsychosocial factors rapidly change to influence health outcomes for individuals and families. The COVID-19 pandemic has resulted in a widespread crisis for perinatal mental health (PMH), compounding issues of access in clinical practice and research. Ambulatory assessment (AA) and the availability of digital technologies may enhance our understanding of the presentation, mechanisms, and treatment of PMH. Specifically, AA (e.g., ecological momentary assessment) may address critical limitations in PMH research, given its ability to improve ecological validity, address multiple levels of analysis (e.g., mood, behavior, physiology, context), and assess real-time dynamics among these processes within and across individuals.
Aim/
Method: This scoping review was thus conducted to investigate the use of AA to examine perinatal psychological distress (PND). PRISMA guidelines were followed; 24 studies were identified.
Results: Limited studies have used AA to examine PND; pregnancy is overrepresented, with few investigations in the postpartum. AA has primarily been used to capture perinatal mood fluctuations in healthy samples. Yet, a few studies suggest AA may be feasible and useful in high-risk populations, such as individuals with substance use disorders or Latinx adolescents in low-resourced areas. AA has been used to capture multiple levels of analysis, including affect, cognition, behavior, health, bonding, physical context, and stress exposure, with several studies collecting objective indices of physiology, behavior, or context through smartphones or wearable technology.
Discussion: Findings provide preliminary support for the feasibility of perinatal AA and its potential to offer insight into the daily dynamics of mood, distress, and health behavior. Significant heterogeneity was observed in the aims, designs, and sample characteristics across studies. Limitations, including insufficient reporting of sociodemographic information and omission of critical contextual variables, will be discussed. Future avenues for research will be discussed, with a focus on improving the accessibility of evidence-based assessment and personalized interventions. Recommendations for enhancing the person-centered, context-aware, and multimodal nature will be discussed in line with biopsychosocial models of PND. A Checklist for the Design and Reporting of Perinatal AA Studies will be provided.