Comparative effectiveness of interventions for the prevention and treatment of perinatal depression: A systematic review and network meta-analysis.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.