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Comparative effectiveness of interventions for the prevention and treatment of perinatal depression: A systematic review and network meta-analysis.

Asian journal of psychiatry
January 1, 2025
Robert David Smith et al. (11 authors)
Journal ArticleSystematic ReviewComparative StudyNetwork Meta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to compare the effectiveness of various interventions, including massage, in treating depression symptoms in perinatal women.

Results Summary

Interpersonal therapy plus massage was the highest-ranking intervention for treating perinatal depression symptoms, with a significant standardized mean difference compared to treatment as usual.

Population

Perinatal women (pregnant or postpartum)

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (22)
InterventionDirectionEndpointPopulationDosageImpactClaim #
mindfulness
decrease
frequency of depression
perinatal women
OR=0.21; 0.06, 0.71 95 %CrI
was the highest-ranking intervention
#1
pharmacological treatments
decrease
frequency of depression
perinatal women
-
significant OR
#2
CBT
decrease
frequency of depression
perinatal women
-
significant OR
#3
physical activities
decrease
frequency of depression
perinatal women
-
significant OR
#4
education
decrease
frequency of depression
perinatal women
-
significant OR
#5
collaborative care
decrease
frequency of depression
perinatal women
-
significant OR
#6
interpersonal therapy plus massage
decrease
depression severity
perinatal women
SMD=-1.38; -2.54, -0.21
was the highest-ranking intervention
#7
IPT
decrease
depression severity
perinatal women
-
significant SMD
#8
alternative therapies
decrease
depression severity
perinatal women
-
significant SMD
#9
physical activities
decrease
depression severity
perinatal women
-
significant SMD
#10
mindfulness
decrease
depression severity
perinatal women
-
significant SMD
#11
CBT
decrease
depression severity
perinatal women
-
significant SMD
#12
collaborative care
decrease
depression severity
perinatal women
-
significant SMD
#13
education
decrease
depression severity
perinatal women
-
significant SMD
#14
enhanced TAU
decrease
depression severity
perinatal women
-
significant SMD
#15
pharmacological treatments
decrease
depression severity
perinatal women
-
were effective
#16
CBT
decrease
perinatal depression symptoms
perinatal women
-
were effective
#17
mindfulness
decrease
perinatal depression symptoms
perinatal women
-
were effective
#18
physical activity
decrease
perinatal depression symptoms
perinatal women
-
were effective
#19
collaborative care
decrease
perinatal depression symptoms
perinatal women
-
were effective
#20
education
decrease
perinatal depression symptoms
perinatal women
-
were effective
#21
pharmacological interventions
decrease
perinatal depression symptoms
perinatal women
-
were effective
#22
Abstract

BACKGROUND: Several interventions have been investigated addressing perinatal depression; however, interventions have not been compared using both direct and indirect evidence. This study compared the relative effectiveness of all interventions that prevent depression (objective 1) or treat depression symptoms (objective 2) in perinatal women. METHODS: Eight databases searched from their inception to March 2024. Inclusion criteria were randomised controlled trials in perinatal women participants evaluating any interventions that addressed prevention or treatment of depression. Two random-effects Bayesian network meta-analyses were conducted using studies with perinatal women participants reporting frequency of depression or reporting depression severity. For objective 1 odds ratios (OR) and objective 2 standardised mean differences (SMD) were used. RESULTS: A total of 177 articles were included (n = 76 objective 1, n = 101 objective 2). For objective 1; mindfulness was the highest-ranking intervention (SCURA=88), with significant OR compared to treatment as usual (TAU) (OR=0.21; 0.06, 0.71 95 %CrI). Other interventions with significant OR, compared to TAU included: pharmacological treatments, CBT, physical activities, education, and collaborative care. For objective 2; interpersonal therapy plus massage was the highest-ranking intervention (SCURA=89) with significant SMD compared to TAU (SMD=-1.38; -2.54, -0.21). Other interventions with significant SMD compared to TAU: IPT, alternative therapies, physical activities, mindfulness, CBT, collaborative care, education, and enhanced TAU. Pharmacological treatments were effective compared to sham/placebo. CONCLUSION: CBT, mindfulness, physical activity, collaborative care, education, and pharmacological interventions were effective in addressing prevention and treatment of perinatal depression symptoms compared to control arms. Healthcare providers may consider offering these interventions to perinatal women.

Medical Subject Headings (MeSH)
HumansFemalePregnancyPregnancy ComplicationsDepressive DisorderPerinatal CareDepressionDepression, PostpartumRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy89/10
Quality85/10
Research Impact Scores
APT Score0.05
Weight Score2.70
Normalized Score0.73
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