BackgroundPeripartum depression is a common disorder; it has very high potential hazards for both patients and their babies. Although peripartum depression therapy have typical options, antidepressant and electroconvulsive, these are not ensured concerning safe of fetus. Recently, repetitive Transcranial Magnetic Stimulation(rTMS) have been emerging as promising treatment for neuropathies including type of depression. Using magnetic field is expected to minimize effect on fetuses when used to treat peripartum depression. In this study, we are considering that whether the rTMS treatment is safe and effective for the mother and fetus in the treatment of peripartum depression.PurposePerforming systematical review, we confirm whether repetitive Transcranial Magnetic Stimulation is suitable treatment option for peripartum depression. MethodsA systematic review followed the PRISMA guidelines and meta-analysis was performed by CMA3 software. We investigated literature prior to July 2020 using databases including MEDLINE, PsycINFO, EMBASE and Cochrane libraries, and conducted bias evaluation for suitable literature. ResultsrTMS have an effect on mitigating depression with SMD = 1.394, 95% CI: 0.944 – 1.843 and. 37% of participants showed remission of the depression and 66% showed responded to repetitive Transcranial Magnetic Stimulation. A few side effect was reported and case of unusual side effect was two. However, we confirmed these are not related to TMS. There were no life-threatening side effects.ConclusionsrTMS might be an attractive alternative treatment for pregnant women who are afraid of chemical effect to their child and life threatening side effect of ECT. Furthermore, rTMS could reduce socioeconomic costs of peripartum depression However, much research is needed to determine standardized protocol and evaluate effectiveness.Systematic review registrationThis systematic review was not registered.

BackgroundPeripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. MethodsWe performed a systematic review followed the PRISMA guidelines. We searched studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method.ResultsThe therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.920 – 1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.777 – 1.233), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346, (95% CI: 0.214 – 0.506), which was a meaningful result. There were no serious side effects to the mothers or fetuses.ConclusionsFrom a variety of perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid the exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.