Interventions to Prevent Perinatal Depression: Evidence Report and Systematic Review for the US Preventive Services Task Force

Abstract

(Abstracted from JAMA 2019;321(6):588–601) Perinatal depression is a common condition that was estimated in 2012 to affect more than 180,000 new mothers (11.5%) annually in the United States and that can have serious impact on mother and infant well-being. Numerous interventions have been proposed to prevent perinatal depression, but there is no commonly agreed-on prevention method, creating a scenario with substantial variation in clinical practice.

Mental disorders and risk factors among pregnant women with depressive symptoms in Sweden—A case‐control study

“…In a Cochrane review from 2007, women who received psychosocial or psychological intervention were significantly less likely to develop postpartum depression compared with those receiving standard care 29 . In a newly published systematic review, O’Connor et al conclude that psychological interventions such as cognitive behavior therapy and interpersonal psychotherapy during pregnancy or after childbirth can reduce the risk for perinatal depression, especially for women with an increased risk of depression 30 …”

Preventing maternal mental health disorders in the context of poverty: pilot efficacy of a dyadic intervention

“…There is increasingly strong evidence supporting a public health initiative to prevent perinatal mood disorders. 4 We report a pilot efficacy trial of PREPP, which is a PPD prevention intervention for at-risk pregnant women that is (1) integrated into OB care to increase accessibility, (2) brief, and (3) designed with the mother-infant dyad in mind. PREPP shows high levels of patient engagement and relatively low attrition in a sample of women living in poverty and provides modest reductions in subclinical depressive and anxiety symptoms in the early fourth trimester.…”

“…2 The national economic costs of not treating these disorders from conception to the first postpartum year is estimated at $7.5 billion. 3 The United States Preventive Services Task Force (USPSTF) recently published a systematic review of primary careerelevant interventions to prevent perinatal depression, defined as a major or minor depressive episode during pregnancy or up to 1 year after childbirth, 4 and recommended that "clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions." 5 This prevention goal requires effective interventions that reach women at risk of, but before, the development of a depressive disorder.…”

A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study

“…Perinatal depression occurs in 12% to 18% of pregnant and postpartum women in the United States. 1,2 Patients and their health care providers are eager to avoid the adverse outcomes for woman, child, and family that are associated with perinatal depression, such as preterm birth, low birth weight, and child developmental problems through adolescence. 3,4 Early breastfeeding cessation and parenting challenges are also well-documented consequences.…”