The effect of perinatal depression treatment for mothers on parenting and child development: A systematic review

Abstract

Antenatal and postpartum depression are very common and have significant consequences for mothers and their children. This review examines which antenatal depression (AD) and postpartum depression (PPD) treatment interventions are most efficacious in improving parenting and/or child development. CINAHL, Scopus, Cochrane Systematic Reviews, Cochrane Controlled Trials, Medline (OVID), Embase (OVID), PsychINFO, PsycARTICLES, AMED, and reference lists were searched. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effect of AD, PPD, or both treatment interventions on parenting and/or child development were included. Meta-analysis was conducted using random effects when possible. Thirty-six trials (within 40 articles) met criteria for review. Interventions include interpersonal psychotherapy (IPT), cognitive behavioural therapy (CBT), peer support, maternal-child interaction guidance, and other interventions, such as massage. For AD, IPT, CBT, and massage produced large effects on parenting (e.g. adjustment and attention toward infant) and child development (e.g. behaviour). For PPD, maternal-child interaction guidance and psychotherapeutic group support produced large effects on parenting (e.g. sense of competence) and child development (e.g. cortisol). However, meta-analysis revealed nonsignificant effects of IPT on maternal-child attachment and CBT on parenting stress. Promising findings exist for IPT, CBT, maternal-child interaction guidance, massage, and psychotherapeutic group support for specific parenting and/or child development outcomes. Additional RCTs using measures already employed in the literature are required to conduct necessary meta-analysis and fully elucidate treatment effects.

The Effect of Maternal Depression on Infant Attachment: A Systematic Review

“…The present review has both strengths and limitations. Most importantly, it differs from other literature reviews in this area by directly analysing the relationship between maternal depression and child attachment [29,30]. Similarly, none of the four meta-analyses conducted so far have examined the distinction between antenatal/prenatal and postnatal depression [72][73][74][75].…”

“…Studies in this area tend to focus on individual sets of variables and lack the global analysis needed to gain a comprehensive understanding of the effects of maternal depression. No such systematic review has yet been carried out in this area; existing studies focus either on a broader developmental context [29] or on the effects of depression treatment [30].…”

Effective treatment of postnatal depression is associated with normal child development

“…2 There remains inconsistent evidence on whether additional interventions to address mother-infant interactions Effective treatment of postnatal depression is associated with normal child development are required to ameliorate the potential effect on child outcomes from postnatal depression. 3 The trial by Alan Stein and colleagues 4 in this issue of The Lancet Psychiatry addressed this question by randomly allocating women with persistent postnatal depression of at least 3 months' duration to receive video-feedback therapy (VFT; an evidence-based intervention known to improve deficits in motherinfant interactions) or progressive muscle relaxation (PMR), while treating women in both groups with optimally delivered cognitive behavioural therapy (CBT). There was no added benefit of the VFT on child cognitive, language, behavioural, or attachment outcomes, which were all in the normal range, and no significant differences in parenting behaviours at 2 years, thus suggesting that the additional intervention was not necessary.…”

Profiles and characteristics of clinical subtypes of perinatal depressive symptoms: A latent class analysis

“…Women are vulnerable to a great many psychological disturbances, especially depression, which often emerges concurrently with other non-psychotic mental disorders (Howard et al, 2014). Prenatal depression prevalence rates range from 7-12%, whereas prevalence of postnatal depression ranges from 10-15% (Letourneau, Dennis, Cosic, & Linder, 2017). Both prenatal and postnatal depression have significant consequences for women and their offspring (American Psychiatric Association, 2013;Stein et al, 2014).…”