Postpartum Psychosocial and Behavioral Health: A Systematic Review of Self-Administered Scales Validated for Postpartum Women in the United States.

PURPOSE Women's poor postpartum psychosocial and behavioral health may negatively affect them and their infants. Validated postpartum screening scales can help to identify problems early, but currently there is limited knowledge in this area. Thus, we conducted a systematic examination of self-administered psychosocial and behavioral scales validated for postpartum women in the United States in the domains of depression, body image, diet, physical activity, smoking, and alcohol use. We examined the characteristics of included scales, their validation samples, and reported psychometric properties. METHOD Nine databases were searched during October 2014 through February 2015. After meeting inclusion/exclusion criteria, article information was extracted independently by two authors, compared, and differences were resolved through discussions. RESULTS The final sample included 23 published articles covering 19 scales. Seventeen were in the domain of depression, and one each in physical activity and dietary domains. None was found in the domains of body image, smoking, or alcohol use. The number of scale items varied from 2 to 35. The majority of scales were originally designed for postpartum women, and validated in one or two postpartum studies with samples of predominantly adult women. If reported, scale reliability coefficients were generally 0.80 or greater and validity coefficients of 0.70 or greater. Five depression scales had favorable sensitivity and specificity using standard cutpoints, but only one was tested across adolescent, low-income, and predominantly ethnic minority postpartum populations. CONCLUSION No U.S.-validated postpartum scales were found for body image, smoking, or alcohol use. Most scales had limited validity testing, and validation was in predominantly advantaged samples. Further scale development and testing are recommended.