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Effectiveness of psychological interventions in preventing postpartum depression in non-depressed women: a systematic review and meta-analysis of randomized controlled trials

Published online by Cambridge University Press:  08 March 2022

Carmen Martín-Gómez Open the ORCID record for Carmen Martín-Gómez [Opens in a new window] ,
Patricia Moreno-Peral ,
Juan A. Bellón ,
Sonia Conejo-Cerón ,
Henar Campos-Paino ,
Irene Gómez-Gómez ,
Alina Rigabert ,
Isabel Benítez  and
Emma Motrico
Carmen Martín-Gómez
Affiliation:
Fundación Pública Andaluza Progreso y Salud, Área de Evaluación de Tecnologías Sanitarias, Sevilla, Spain Grupo de Investigación (HUM604). Desarrollo de estilos de vida en el ciclo vital y promoción de la salud. Universidad de Huelva, Huelva, Spain
Patricia Moreno-Peral*
Affiliation:
Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
Juan A. Bellón
Affiliation:
Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain El Palo Health Centre, Andalusian Health Service (SAS), Málaga, Spain Department of Public Health and Psychiatry, University of Málaga (UMA), Málaga, Spain
Sonia Conejo-Cerón
Affiliation:
Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
Henar Campos-Paino
Affiliation:
Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
Irene Gómez-Gómez
Affiliation:
Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain
Alina Rigabert
Affiliation:
Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain Fundación Andaluza Beturia para la Investigación en Salud (FABIS), Huelva, Spain
Isabel Benítez
Affiliation:
Department of Methodology of Behavioural Sciences, University of Granada, Granada, Spain
Emma Motrico
Affiliation:
Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain
*
Author for correspondence: Patricia Moreno-Peral, E-mail: [email protected] Emma Motrico, E-mail: [email protected]
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Abstract

Postpartum depression (PPD) is one of the most common disorders following childbirth. This systematic review and meta-analysis (SR/MA) aimed to assess the effectiveness of psychological interventions in preventing PPD in non-depressed women. PRISMA guidelines were followed. MEDLINE (Ovid and PubMed), PsycINFO, Web of Science, Scopus, CINAHL, CENTRAL, OpenGrey, Australian New Zealand Clinical Trial Registry and clinicaltrial.gov were searched. Randomized controlled trials (RCTs) conducted with pregnant or postpartum (up to 12 months) women who were non-depressed at baseline were selected. The outcomes were the incidence of PPD and/or the reduction of postpartum depressive symptoms. The standardized mean difference (SMD) using random-effect models was calculated. Sensitivity, sub-group and meta-regression analyses were performed. 17 RCTs were included in the SR and 15 in the MA, representing 4958 participants from four continents. The pooled SMD was −0.175 [95% confidence interval (CI) −0.266 to −0.083; p < 0.001] and sensitivity analyses confirmed the robustness of this result. Heterogeneity was low (I2 = 21.20%) and was fully explained by a meta-regression model including one variable (previous deliveries). The meta-regression model and MA stratified by previous deliveries indicated that interventions focused on primiparous women are more effective. There was no evidence of publication bias. Few RCTs had an overall low risk of bias. According to GRADE, the quality of evidence was moderate. Psychological interventions have very little effectiveness in preventing PPD in non-depressed women, although this effectiveness is greater in interventions focused on primiparous women. Further RCTs with a low risk of bias and more effective interventions are needed.

Keywords

Depressionmeta-analysispostpartumrandomized controlled trialsystematic review
Type
Review Article
Information
Psychological Medicine , Volume 52 , Issue 6 , April 2022 , pp. 1001 - 1013
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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