***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Two trials met criteria for an RCT of antenatal psychosocial assessment. One trial examined the impact of an antenatal tool (ALPHA) on clinician awareness of psychosocial risk, and the capacity of the antenatal ALPHA to predict women with elevated postnatal Edinburgh Depression Scale (EDS) scores, finding a trend towards increased clinician awareness of 'high level' psychosocial risk where the ALPHA intervention had been used (relative risk (RR) 4.61 95% confidence interval (CI) 0.99 to 21.39). No differences between groups were seen for numbers of women with antenatal EDS scores, a score of greater than 9 being identified by ALPHA as of concern for depression (RR 0.69 95% CI 0.35 to 1.38); 139 providers. The other trial reported no differences in EPS scores greater than 12 at 16 weeks postpartum between the intervention (communication about the EDS scores with the woman and her healthcare providers plus a patient information booklet) and the standard care groups (RR 0.86 95% CI 0.61 to 1.21; 371 women). While the use of an antenatal psychosocial assessment may increase the clinician's awareness of psychosocial risk, neither of these small studies provides sufficient evidence that routine antenatal psychosocial assessment by itself leads to improved perinatal mental health outcomes. Further studies with better sample size and statistical power are required to further explore this important public health issue. It will also be important to examine outcomes up to one year postpartum not only for mother, but also infant and family.
Output:

The one study that met the criteria for this review randomised healthcare providers to either psychosocial assessment or routine care and involved a total of 273 women. The providers who assessed psychosocial factors were more likely than those giving routine care to identify psychosocial concerns and to rate the level of concern as high. They were also more likely to detect concerns about family violence. The trial did not look at the development of anxiety or depression in these women. Not all healthcare providers chose to take part in the trial and some dropped out, leaving only 48 of the original 185 approached. This could mean that providers who were less interested in this area of clinical practice did not participate and bias the findings toward better than average detection of psychosocial risk. Two studies are currently in progress looking at the impact of early postnatal psychosocial assessment on the prevalence of antenatal and postnatal anxiety and depression.