Effects of parenting interventions for mothers with depressive symptoms and an infant: systematic review and meta-analysis

Abstract

Background Postpartum depression is common in the perinatal period and poses a risk for the development of the infant and the mother–infant relationship. Infancy is a critical developmental period of life and supportive parenting is crucial for healthy development, however, the effects of interventions aimed at improving parenting among mothers with depression are uncertain. Aims To assess the effects of parenting interventions on parent–child relationship and child development among mothers with depressive symptoms with 0–12-month-old infants. Method We conducted a systematic review with the inclusion criteria: (a) randomised controlled trials of structured psychosocial parenting interventions for women with depressive symptoms and a child aged 0–12 months in Western Organisation for Economic Co-operation and Development countries, (b) minimum three sessions with at least half of these delivered postnatally and (c) outcomes relating to the parent–child-relationship and/or child development. Publications were extracted from 10 databases in September 2018 and supplemented with grey search and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analysis. Results Eight papers representing seven trials were included. We conducted meta-analysis on the post-intervention parent–child relationship. The analysis included six studies and showed no significant effect. For individual study outcomes, no significant effects on the majority of both the parent–child relationship and child development outcomes were reported. Conclusions No evidence of the effect of parenting interventions for mothers with depressive symptoms was found on the parent–child relationship and child development. Larger studies with follow-up assessments are needed, and future reviews should examine the effects in non-Western countries.

Supporting early infant relationships and reducing maternal distress with the Newborn Behavioral Observations: A randomized controlled effectiveness trial

“…Positive screening within obstetric and maternal and child health (MCH) services prompts referral for individual pharmacological treatment and psychotherapy, however converting distress identification to help‐seeking and effective care remains challenging and reflects multiple barriers to accessing care such as stigma (Holt et al., 2017). The optimum, feasible front‐line intervention approach to maternal distress and its impacts is not established (Belkin et al., 2017; Howard & Khalifeh, 2020; Rayce et al., 2020). Relationship‐focused intervention has been effective in a low socio‐economic setting, but the effectiveness has not been replicated in a high‐income country (P. Cooper et al., 2015; P. J. Cooper et al., 2009).…”

One-year follow-up of The Incredible Years Parents and Babies Program: A pilot randomized controlled trial

“…Compared to older children, infants are also more sensitive to disruptions in parental care. Infants with mothers suffering from depression or severe stress can show biochemical, physiological, and behavioral dysregulations beginning shortly after birth, and may be at increased risk of mental and behavioral problems ( 11 – 13 ). These infants often show high levels of negative emotion and distress and have a higher risk of developing an insecure attachment to their caregivers ( 14 , 15 ).…”

Social inequality in parent–infant relations: Epidemiological study of community nurse records

“…Recent reviews of randomized controlled studies show mixed results regarding the effects of universally provided parent training [24,25]. Other reviews draw a much more positive picture of the effects of targeted efforts to stimulate the parent–infant relation by means of training and psychoeducation of parents [24,26–30].…”