The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis
Abstract Background Postpartum mental disorders including depression and anxiety are common. Medical complications of pregnancy, such as preeclampsia and gestational diabetes, are thought to increase the risk of mental disorders postpartum. However, it is unclear which interventions may be effective...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05084-1 |
| _version_ | 1811233745035853824 |
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| author | Jie Shang Nadila Dolikun Xuanchen Tao Puhong Zhang Mark Woodward Maree L. Hackett Amanda Henry |
| author_facet | Jie Shang Nadila Dolikun Xuanchen Tao Puhong Zhang Mark Woodward Maree L. Hackett Amanda Henry |
| author_sort | Jie Shang |
| collection | DOAJ |
| description | Abstract Background Postpartum mental disorders including depression and anxiety are common. Medical complications of pregnancy, such as preeclampsia and gestational diabetes, are thought to increase the risk of mental disorders postpartum. However, it is unclear which interventions may be effective for preventing and/or treating postpartum mental disorders following a medically complicated pregnancy. We aimed to systematically review published literature on the effectiveness of postpartum interventions to improve women’s mental health after medical complications of pregnancy. Methods Systematic review (PROSPERO: CRD42021220030) was performed. Eligibility criteria: (1) randomized controlled trials (RCTs), published 1st Jan 2001-12th August 2021 (2) outcome measures reported on postpartum mental disorders (3) participants had ≥ 1 medical complication during pregnancy (4) intervention entirely postpartum or contained a postpartum component (5) full-text available in English or Chinese. Risk of bias was assessed using the Revised Cochrane Criteria Risk of Bias. Random effects inverse-variance weighted meta-analysis was used to pool the individual standardized mean differences (SMD) in depression or anxiety scores between intervention and control groups. Results Of 5928 studies screened, 9 met inclusion criteria, and were based on non-pharmaceutical, combined lifestyle interventions that began shortly after childbirth, or as part of extended care packages beginning during pregnancy. Of these, 2 were rated as low risk of bias, 1 with some concerns, and 6 were at high risk. Meta-analysis was performed for 8 studies using standardized measures of depression and 7 for anxiety. There were statistically significant reductions in depression (SMD − 1.48; 95%CI: -2.41 to -0.55), and anxiety scores (SMD − 1.98; 95%CI: -3.03 to -0.94) in intervention versus control groups. Considerable heterogeneity was noted for pooled depression (I2 = 97.9%, p < 0.05), and anxiety (I2 = 96.8%, p < 0.05) results. Conclusion Limited intervention studies aimed at improving postpartum mental disorders after medically complicated pregnancy were found, most with a high risk of bias. There was some evidence to suggest that postpartum depression and anxiety scores improved after early intervention. However, in general the current quality of evidence is low. Further, high-quality, interventional research is required in this understudied field. |
| first_indexed | 2024-04-12T11:25:39Z |
| format | Article |
| id | doaj.art-9703ac01e0aa47d09deab13e1b504d38 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T11:25:39Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-9703ac01e0aa47d09deab13e1b504d382022-12-22T03:35:15ZengBMCBMC Pregnancy and Childbirth1471-23932022-11-0122111310.1186/s12884-022-05084-1The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysisJie Shang0Nadila Dolikun1Xuanchen Tao2Puhong Zhang3Mark Woodward4Maree L. Hackett5Amanda Henry6Discipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and HealthThe George Institute for Global HealthDiscipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and HealthThe George Institute for Global HealthThe George Institute for Global Health, Faculty of Medicine and Health, University of New South WalesThe George Institute for Global Health, Faculty of Medicine and Health, University of New South WalesDiscipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and HealthAbstract Background Postpartum mental disorders including depression and anxiety are common. Medical complications of pregnancy, such as preeclampsia and gestational diabetes, are thought to increase the risk of mental disorders postpartum. However, it is unclear which interventions may be effective for preventing and/or treating postpartum mental disorders following a medically complicated pregnancy. We aimed to systematically review published literature on the effectiveness of postpartum interventions to improve women’s mental health after medical complications of pregnancy. Methods Systematic review (PROSPERO: CRD42021220030) was performed. Eligibility criteria: (1) randomized controlled trials (RCTs), published 1st Jan 2001-12th August 2021 (2) outcome measures reported on postpartum mental disorders (3) participants had ≥ 1 medical complication during pregnancy (4) intervention entirely postpartum or contained a postpartum component (5) full-text available in English or Chinese. Risk of bias was assessed using the Revised Cochrane Criteria Risk of Bias. Random effects inverse-variance weighted meta-analysis was used to pool the individual standardized mean differences (SMD) in depression or anxiety scores between intervention and control groups. Results Of 5928 studies screened, 9 met inclusion criteria, and were based on non-pharmaceutical, combined lifestyle interventions that began shortly after childbirth, or as part of extended care packages beginning during pregnancy. Of these, 2 were rated as low risk of bias, 1 with some concerns, and 6 were at high risk. Meta-analysis was performed for 8 studies using standardized measures of depression and 7 for anxiety. There were statistically significant reductions in depression (SMD − 1.48; 95%CI: -2.41 to -0.55), and anxiety scores (SMD − 1.98; 95%CI: -3.03 to -0.94) in intervention versus control groups. Considerable heterogeneity was noted for pooled depression (I2 = 97.9%, p < 0.05), and anxiety (I2 = 96.8%, p < 0.05) results. Conclusion Limited intervention studies aimed at improving postpartum mental disorders after medically complicated pregnancy were found, most with a high risk of bias. There was some evidence to suggest that postpartum depression and anxiety scores improved after early intervention. However, in general the current quality of evidence is low. Further, high-quality, interventional research is required in this understudied field.https://doi.org/10.1186/s12884-022-05084-1Pregnancy complication(s)Postpartum mental healthPostpartum depressionPostpartum anxietyRandomised controlled trialGestational diabetes mellitus |
| spellingShingle | Jie Shang Nadila Dolikun Xuanchen Tao Puhong Zhang Mark Woodward Maree L. Hackett Amanda Henry The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis BMC Pregnancy and Childbirth Pregnancy complication(s) Postpartum mental health Postpartum depression Postpartum anxiety Randomised controlled trial Gestational diabetes mellitus |
| title | The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis |
| title_full | The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis |
| title_fullStr | The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis |
| title_full_unstemmed | The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis |
| title_short | The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis |
| title_sort | effectiveness of postpartum interventions aimed at improving women s mental health after medical complications of pregnancy a systematic review and meta analysis |
| topic | Pregnancy complication(s) Postpartum mental health Postpartum depression Postpartum anxiety Randomised controlled trial Gestational diabetes mellitus |
| url | https://doi.org/10.1186/s12884-022-05084-1 |
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