Keywords
prevention and control
risk factors
psychotherapy
exercise
mindfulness
social support
How to Cite
Abstract
Introduction: postpartum depression is the most frequent peripartum psychiatric complication, it constitutes a public health problem due to short and long-term consequences for mother and child. It is considered that the preventive approach has great potential toreduce its incidence, as well as the evaluation of efficacy in nterventions, according to the targeted population group, contributes to determining specific therapies and reducing health costs. Objective: evaluate and compare the efficacy of non-pharmacological interventions for the prevention of postpartum depression in pregnant women with risk factors compared to pregnant women in the general maternal population. Methods: a systematic research was carried out in the MEDLINE, SCOPUS, CINAHL, EMBASE and LILACS databases, through which 484 articles limited to English and Spanish languages were identified, to finally include, according to eligibility criteria and methodological quality, a total of 13 controlled clinical trials, covering a sample of 5,905 patients. Results: six of the seven
studies of women with risk factors had a favorable impact on both the decrease in symptoms and the score on the measurement scales over time. In contrast, only two of the six studies in the general population had a significant impact. The most important limitation was the heterogeneity of the proposed interventions. Conclusions: findings suggest that non-pharmacological preventive interventions are more effective in preventing depression when approached in women with risk factors and in the postpartum period. MÉD.UIS.2021;34(1): 73-90.
References
Afshari, P, Tadayon, M, Abedi, P, Yazdizadeh, S. Prevalence and related factors of postpartum depression among reproductive aged women in Ahvaz, Iran. Health Care Women Int. 2019;41(3):1–11.
Mendoza C, Saldivia S. Actualización en depresión postparto: el desafío permanente de optimizar su detección y abordaje. Rev. méd. Chile. 2015;143(7):887-894.
Asociación Americana de Psiquiatría. Manual Diagnóstico y Estadístico de los Trastornos Mentales, quinta edición (DSM-V). Arlington (VA), EE.UU: American Psychiatric Association Publishing; 2013.
Stewart DE, Vigod SN. Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics. Annu. Rev. Med. 2019;70(1):183–196.
Norhayati MN, Nik Hazlina NH, Asrenee AR, Wan Emilin WMA. Magnitude and risk factors for postpartum symptoms: Aliterature review. J Affect Disord. 2015;175(1):34–52.
World Health Organization. Maternal mental health. [online] Disponible en: https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health.
Barrera AZ, Nichols AD. Depression help-seeking attitudes and behaviors among an Internet based sample of Spanishspeaking perinatal women. Rev Panam Salud Publica. 2015;37(3):148–53.
Sefogah PE, Samba A, Mumuni K, Kudzi W. Prevalence and key predictors of perinatal depression among postpartum women in Ghana. Int. J. Gynecol. Obstet. 2020;149:203-210.
Romero D, Orozco LA, Ybarra JL, Gracia BI. Sintomatología depresiva en el post parto y factores psicosociales asociados. Rev. chil. obstet. ginecol. 2017;82(2):152-162.
Rincón-Pabón D, Ramírez-Vélez R. Postnatal depression in Colombian women: secondary analysis of the 2010 Colombian Demographic and Health Survey. Rev. salud pública. 2014;16(4):534-546.
Ammerman RT, Scheiber FA, Peugh, JL, Messer EP, Van Ginkel JB, Putnam FW. Interpersonal trauma and suicide attempts in lowincome depressed mothers in home visiting. Child Abuse Negl.2019;97:104126.
Al Nasr RS, Altharwi K, Derbah MS, Gharibo SO, Fallatah SA, Alotaibi SG, et al. Prevalence and predictors of postpartum epression in Riyadh, Saudi Arabia: A cross sectional study. PLOS ONE. 2020;15(2):e0228666.
Martín-Gómez C, Moreno-Peral P, Bellón JA, Conejo-Cerón S, Campos-Paino H, Gómez-Gómez I, et al. Effectiveness of sychological, psychoeducational and psychosocial interventions to prevent postpartum depression in adolescent and adult mothers: study protocol for a systematic review and meta-analysisof randomised controlled trials. BMJ Open. 2020;10(5):e034424.
Cho HJ, Kwon JH, Lee JJ. Antenatal Cognitive-behavioral Therapy for Prevention of Postpartum Depression: A Pilot Study. Yonsei Med J. 2008;49(4):553–562.
Tandon SD, Perry DF, Mendelson T, Kemp K, Leis JA. Preventing perinatal depression in low-income home visiting clients: A randomized controlled trial. J Consult Clin Psychol. 2011;79(5):707–712.
Stein A., Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. The Lancet. 2014;384(9956):1800–1819.
Guo L, Zhang J, Mu L, Ye Z. Preventing Postpartum Depression With Mindful Self-Compassion Intervention. J Nerv Ment Dis. 2020;208(2):101-107.
Maternal depression and child development. J Paediatr Child Health. 2004;9(8):575-598.
Beck, CT. Predictors of Postpartum Depression. Nurs Res. 2001;50(5):275–85.
Becker M, Weinberger T, Chandy A, & Schmukler, S. Depression During Pregnancy and Postpartum. Curr Psychiatry Rep. 2016;18(3):32.
Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26(4):289–95.
The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. Obstet Gynecol. 2015;125(5):1268–71.
Campo A, Ayola C, Peinado H, Amor M, Cogollo Z. Escala de Edinburgh para depresión posparto: consistencia interna yestructura factorial en mujeres embarazadas de Cartagena, Colombia. Rev Colomb Obstet Ginecol. 2007;58(4):277-83.
Chorwe G, Chipps J. A systematic review of screeningnstruments for depression for use in antenatal services in lowresource settings. BMC Psychiatry. 2017;17(1):112.
ACOG Committee Opinion No. 757. Obstet Gynecol. 2018;132(5):208–12.
Radloff LS. The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.
Mosack V, Shore E. Screening for Depression among Pregnant andPostpartum Women. J. Community Health Nurs. 2006;23(1):37-47.
Records K, Rice M, & Beck CT. Psychometric Assessment of the Postpartum Depression Predictors Inventory–Revised. J Nurs Meas. 2007;15(3):189–202.
Gorman LL, O’Hara MW, Figueiredo B, Hayes S, Jacquemain F, Kammerer MH, et al. Adaptation of the Structured Clinical Interview for DSM-IV Disorders for assessing depression in women during pregnancy and post-partum across countries and cultures. Br J Psychiatry. 2004;184(S46):s17–s23.
Ruyak SL, Qeadan, F. Use of the Antenatal Risk Questionnaire to Assess Psychosocial Risk Factors Associated with Risk for Postpartum Depression: A Pilot Study. J Midwifery Womens Health. 2018; 63:578-83.
Werner E, Miller M, Osborne LM, Kuzava S, Monk C. Preventing postpartum depression: review and recommendations. Archv Womens Ment Health. 2014;18(1),41–60.
Wang Y, Li H, Peng W, Chen Y, Qiu M, Wang J, et al. Nonpharmacological interventions for postpartum depression. Medicine (Baltimore). 2020;99(31):e21496.
Chabrol H, Teissedre F, Saint-Jean M, Teisseyre N, Roge B, Mullet E. Prevention and treatment of post-partum depression: a controlled randomized study on women at risk. Psychol Med. 2002;32(6):1039–47.
Cho HJ, Kwon JH, Lee JJ. Antenatal cognitive-behavioral therapy for prevention of postpartum depression: a pilot study. Yonsei Med J. 2008;49(4):553–62.
Milgrom J, Schembri C, Ericksen J, Ross J, Gemmill AW. Towards parenthood: an antenatal intervention to reduce depression, anxiety and parenting difficulties. J Affect Disord. 2011;130(3):385–94.
Stephens S, Ford E, Paudyal P, Smith H. Effectiveness of Psychological Interventions for Postnatal Depression in Primary Care: A Meta-Analysis. Ann Fam Med. 2016;14(5):463-72.
Records K, Rice M, Beck CT. Psychometric Assessment of the tpartum Depression Predictors Inventory–Revised. J Nurs Meas. 2007;15(3):189–202.
Gorman LL, O’Hara MW, Figueiredo B, Hayes S, Jacquemain F, Kammerer MH, et al. Adaptation of the Structured Clinical Interview for DSM-IV Disorders for assessing depression in women during pregnancy and post-partum across countries and cultures. Br J Psychiatry Suppl. 2004;184(S46): s17–s23.
Duncan LG, Cohn MA, Chao MT, Cook JG, Riccobono J, Bardacke N. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth. 2017;17:140.
Bowen A, Baetz M, Schwartz L, Balbuena L, Muhajarine N. Antenatal group therapy improves worry and depression symptoms. Isr J Psychiatry Relat Sci. 2014;51(3):226-31.
Sacristan-Martin O, Santed MA, Garcia-Campayo J, Duncan LG, Bardacke N, Fernandez-Alonso C, et al. A mindfulness and compassion-based program applied to pregnant women and their partners to decrease depression symptoms during pregnancy and postpartum: study protocol for a randomized controlled trial. Trials. 2019;20(1):654.
Dennis, C.-L., & Letourneau, N. Global and relationship-specific perceptions of support and the development of postpartum depressive symptomatology. Soc Psychiatry Psychiatr Epidemiol. 2007;42(5), 389–395.
Lin N, Ye X, Ensel WM. Social support and depressed mood: a structural analysis. J Health Soc Behav. 1999;40:344-59.
Thoits PA. Social support as coping assistance. J Consult Clin Psychol. 1986;54:416-23.
ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol. 2015;126(6), e135–e142.
Ersek JL, Brunner Huber LR. Physical Activity Prior to and During Pregnancy and Risk of Postpartum Depressive Symptoms. J Obstet Gynecol Neonatal Nurs. 2009;38(5):556–66.
Da Costa D, Rippen N, Dritsa M, Ring A. Self-reported leisuretime physical activity during pregnancy and relationship to psychological well-being. J Psychosom Obstet Gynaecol. 2003;24(2),111–9.
Werner E, Miller M, Osborne LM, Kuzava S, Monk C. Preventing postpartum depression: review and recommendations. Arch Womens Ment Health. 2014;18(1),41–60.
Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, et al. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technol Assess. 2016;20(37):1-414.
Chabrol H, Teissedre F, Saint-Jean M, Teisseyre N, Rogé B, Mullet E. Prevention and treatment of post-partum depression: a controlled randomized study on women at risk. Psychol Med. 2002;32(6):1039-47.
Arango C, Díaz-Caneja CM, McGorry PD, Rapoport J, Sommer IE, Vorstman JA, et al. Preventive strategies for mental health. Lancet Psychiatry. 2018;5(7):591-604.
Bauer A, Knapp M, McDaid D. Assessing the Economic Pay‐off of Low‐level Interventions in Reducing Postnatal Depression [Internet]. LSE Health and Social Care; 2012 [citado 2021 mar 22]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963067/.
Frieder A, Fersh M, Hainline R, Deligiannidis KM. Pharmacotherapy of postpartum depression: current approaches and novel drug development. CNS Drugs. 2019;33(3):265–82.
Yasuma N, Narita Z, Sasaki N, Obikane E, Sekiya J, Inagawa T, et al. Psychological intervention for universal prevention of antenatal and postnatal depression among pregnant women: protocol for a systematic review and meta-analysis. Syst Rev. 2019;8(1):297.
Dennis CL, Creedy DK. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev. 2004;4:CD001134.
Dukhovny D, Dennis CL, Hodnett E, Weston J, Stewart D, Mao W, et al. Prospective economic evaluation of a peer support intervention for prevention of postpartum depression among high-risk women in Ontario, Canada. Am J Perinatol. 2013;30(8):631–42
Nakku JE, Nakasi G, Mirembe F. Postpartum major depression at six weeks in primary health care: prevalence and associated factors. Afr Health Sci. 2006;6(4):207–214.
Pan WL, Chang CW, Chen SM, Gau ML. Assessing the effectiveness of mindfulness-based programs on mental health during pregnancy and early motherhood - A randomized control trial. BMC Pregnancy Childbirth. 2019;19(1):1–8.
Tandon SD, Ward EA, Hamil JL, Jimenez C, Carter M. Perinatal depression prevention through home visitation: a cluster randomized trial of mothers and babies 1-on-1. J Behav Med. 2018;41(5):641-52.
Jiang L, Wang ZZ, Qiu LR, Wan GB, Lin Y, Wei Z. Psychological intervention for postpartum depression J. Huazhong Univ. Sci. Technol. [Med. Sci.] 2014;34(3):437-42.
Austin MP, Frilingos M, Lumley J, Hadzi-Pavlovic D, Roncolato W, Acland S, et al. Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial. J Affect Disord. 2008;105(1-3):35-44.
Haga SM, Drozd F, Lisøy C, Wentzel-Larsen T, Slinning K. Mamma Mia–A randomized controlled trial of an internetbased intervention for perinatal depression. Psychol Med. 2019;49(11):1850-8.
De Vargas C, Rodriguez M, Stein A, Gonçalves B, Garcia D, Pires F, et al. Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial. JAMA Netw open. 2019;2(1):e186861.
Songøygard KM, Stafne SN, Evensen KAI, Salvesen KÅ, Vik T, Mørkved S. Does exercise during pregnancy prevent postnatal depression?: A randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91(1):62–7.
Dennis CL, Hodnett E, Kenton L, Weston J, Zupancic J, Stewart DE, Kiss A. Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial. BMJ. 2009;338:a3064.
Fonseca A, Alves S, Monteiro F, Gorayeb R, Canavarro MC. Be a Mom, a web-based intervention to prevent postpartum depression: results from a pilot randomized controlled trial. Behavior Therapy. 2020;51(4):616-33.
Lara MA, Navarro C, Navarrete L. Outcome results of a psychoeducational intervention in pregnancy to prevent PPD: A randomized control trial. J Affect Disord. 2010;122(1-2):109-17.
Ngai FW, Wong PC, Chung KF, Chau PH, Hui PW. Effect of couple‐based cognitive behavioural intervention on prevention of postnatal depression: multisite randomised controlled trial. BJOG. 2020;127(4):500-7.
Vismara L, Sechi C, Lucarelli L. Reflective parenting home visiting program: A longitudinal study on the effects upon depression, anxiety and parenting stress in first-time mothers. Heliyon. 2020;6(7):e04292.
Özkan SA, Kücükkelepce DS, Korkmaz B, Yılmaz G, Bozkurt MA. The effectiveness of an exercise intervention in reducing the severity of postpartum depression: A randomized controlled trial. Perspect Psychiatr Care. 2020;56(4):844-50.
Sockol LE. A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression. J Affect Disord. 2015;177:7-21.
Nagy E, Moore S. Social interventions: An effective approach to reduce adult depression? J Affect Disord. 2017;218:131-152.
Horowitz JA, Murphy CA, Gregory K, Wojcik J, Pulcini J, Solon L. Nurse home visits improve maternal/infant interaction and decrease severity of postpartum depression. J Obstet Gynecol Neonatal Nurs. 2013;42(3):287-300.
Nakamura A, van der Waerden J, Melchior M, Bolze C, El-Khoury F, Pryor L. Physical activity during pregnancy and postpartum depression: Systematic review and meta-analysis. J Affect Disord. 2019;246:29–41.
Pritchett R V., Daley AJ, Jolly K. Does aerobic exercise reduce postpartum depressive symptoms?: A systematic review and meta-analysis. Br J Gen Pract. 2017;67(663):e684–91.
Daley AJ, Foster L, Long G, Palmer C, Robinson O, Walmsley H, et al. The effectiveness of exercise for the prevention and treatment of antenatal depression: Systematic review with meta-analysis. BJOG. 2015;122(1):57–62.
Carter T, Bastounis A, Guo B, Morrell CJ. The effectiveness of exercise-based interventions for preventing or treating postpartum depression: a systematic review and meta-analysis. Arch Womens Ment Health. 2019;22(1):37–53.
Fontein-Kuipers YJ, Nieuwenhuijze MJ, Ausems M, Budé L, De Vries R. Antenatal interventions to reduce maternal distress: A systematic review and meta-analysis of randomised trials. BJOG. 2014;121(4):389–97.
Campolong K, Jenkins S, Clark MM, Borowski K, Nelson N, Moore KM, et al. The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women. Arch Womens Ment Health. 2018;21(2):215–24.
Shorey S, Ang L, Hon B, Yin C. A systematic mixed-studies review on mindfulness- based childbirth education programs and maternal outcomes. Nursing Outlook. 2019;67(6):696–706.
Sheffield KM, Woods-Giscombé CL. Efficacy, feasibility, and acceptability of perinatal yoga on women’s mental health and well-being: a systematic literature review. J Holist Nurs. 2016;34(1):64–79.
Taylor BL, Cavanagh K, Strauss C. The Effectiveness of MindfulnessBased Interventions in the Perinatal Period: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(5):1–29.
Smith CA, Shewamene Z, Galbally M, Schmied V, Dahlen H. The effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis. J Affect Disord. 2019;245(1):428-39.
Gaston A, Cramp A. Exercise during pregnancy: A review of patterns and determinants. J Sci Med Sport. 2011;14(4):299–305.
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