A randomized controlled trial: effects of a prenatal depression intervention on perinatal outcomes among Chinese high-risk pregnant women with medically defined complications

Zhao, Ying; Munro‐Kramer, Michelle L.; Shi, Sheng; Wang, Jing; Luo, Jianfeng

doi:10.1007/s00737-016-0712-7

Cited by 21 publications

(71 citation statements)

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“…Our study results were consistent with his findings on the psychological response and clearly testify that psychological interventions with tailored interventions meet the real demand of highrisk pregnant women. The perinatal outcomes were described elsewhere (Zhao, Munro-Kramer, Shi, Wang, & Luo, 2017).…”

Section: Discussionmentioning

confidence: 99%

Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial

Zhao

Munro‐Kramer

Shi

et al. 2018

Early Intervention Psych

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Section: Discussionmentioning

confidence: 99%

Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial

Zhao

Munro‐Kramer

Shi

et al. 2018

Early Intervention Psych

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“…Population: most trials were conducted in upper-middle-income countries (Brazil, Chile, China, Iran, Lebanon, Malaysia, Mexico and South Africa) (Langer et al, 1998;Bastani et al, 2006;Aracena et al, 2009;Carvalho et al, 2009;Cooper et al, 2009;Le Roux et al, 2013;Le Roux et al, 2014; Rotheram-Borus et al, 2014a; Rotheram-Borus et al, 2014b; Tomlinson, 2014; Karamoozian and Askarizadeh, 2015;Murray et al, 2015;Tomlinson et al, 2015;Tomlinson et al, 2016b;Tomlinson et al, 2016a;Zhao et al, 2017, Rotheram-Fuller et al, 2018Mohd Shukri et al, 2019;Nabulsi et al, 2019;Rotheram-Borus et al, 2019;Guo et al, 2020;Zhao et al, 2020) followed by lower-middle-income (India, Nigeria and Pakistan) (Rahman et al, 2008;Tripathy et al, 2010;Maselko et al, 2015;Dabas et al, 2019;Fuhr et al, 2019;Gureje et al, 2019;Sikander et al, 2019;Rajeswari and SanjeevaReddy, 2020), low-income (Pakistan) (Rahman et al, 2008;Maselko et al, 2015) and a multi-site trial of lower-middle (Cuba) and upper-middle-income countries (Argentina, Brazil and Mexico) (Villar et al, 1992) (Table 1). Most trials enrolled pregnant women in their second and/or third trimester (Villar et al, 1992; Epidemiology and Psychiatric Sciences Langer et al, 1998;Bastani et al, 2006;Rahman et al, 2008;Aracena et al, 2009;Co...…”

Section: Overview Of Study Characteristics and Qualitymentioning

confidence: 99%

Impact of maternal mental health interventions on child-related outcomes in low- and middle-income countries: a systematic review and meta-analysis

Tol

Greene

Lasater

et al. 2020

Epidemiol Psychiatr Sci

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Aims Observational studies have shown a relationship between maternal mental health (MMH) and child development, but few studies have evaluated whether MMH interventions improve child-related outcomes, particularly in low- and middle-income countries. The objective of this review is to synthesise findings on the effectiveness of MMH interventions to improve child-related outcomes in low- and middle-income countries (LMICs). Methods We searched for randomised controlled trials conducted in LMICs evaluating interventions with a MMH component and reporting children's outcomes. Meta-analysis was performed on outcomes included in at least two trials. Results We identified 21 trials with 28 284 mother–child dyads. Most trials were conducted in middle-income countries, evaluating home visiting interventions delivered by general health workers, starting in the third trimester of pregnancy. Only ten trials described acceptable methods for blinding outcome assessors. Four trials showed high risk of bias in at least two of the seven domains assessed in this review. Narrative synthesis showed promising but inconclusive findings for child-related outcomes. Meta-analysis identified a sizeable impact of interventions on exclusive breastfeeding (risk ratio = 1.39, 95% confidence interval (CI): 1.13–1.71, ten trials, N = 4749 mother–child dyads, I2 = 61%) and a small effect on child height-for-age at 6-months (std. mean difference = 0.13, 95% CI: 0.02–0.24, three trials, N = 1388, I2 = 0%). Meta-analyses did not identify intervention benefits for child cognitive and other growth outcomes; however, few trials measured these outcomes. Conclusions These findings support the importance of MMH to improve child-related outcomes in LMICs, particularly exclusive breastfeeding. Given, the small number of trials and methodological limitations, more rigorous trials should be conducted.

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“…Birth weight was not significantly affected by interventions as compared to control conditions, corresponding to a mean difference of 42.88 g (95% CI − 33.06 to 118.83, N = 11, n = 1583, I 2 = 39% [ 45 , 47 , 49 , 50 , 52 – 55 , 57 , 59 , 60 ]) between the intervention and control groups. Gestational age and Apgar scores did not significantly improve or worsen by prenatal interventions (gestational age mean difference = 0.08 weeks [95% CI −0.09 to 0.24], N = 10, n = 1669, I 2 = 0% [ 49 , 50 , 52 , 53 , 55 – 57 , 59 , 60 ]; Apgar mean difference = 0.21 [95% CI −0.28 to 0.71], N = 4, n = 663, I 2 = 68% [ 51 , 52 , 55 , 57 ]). The pooled effect size indicated an overall non-significant effect on Apgar scores, birth weight, and gestational age together.…”

Section: Resultsmentioning

confidence: 94%

“… ? + – L Zhao, 2017 [ 49 ] Depression EPDS ≥ 9 or PDSS ≥ 20 IG: 6 sessions couple-separated psycho-educational program for first time parents CG: TAU Prenatal IG, 175; CG, 174; Total, 349 Yes, on depressive status Medical records: GA, BW China + ? ?…”

Section: Resultsmentioning

confidence: 99%

Offspring outcomes after prenatal interventions for common mental disorders: a meta-analysis

Brouwer

Williams

Grinsven

et al. 2018

BMC Med

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BackgroundIt is presumed that pharmacological and non-pharmacological treatment of prenatal common mental disorders can mitigate associated adverse effects in offspring, yet strong evidence for the prophylactic benefits of treatment is lacking. We therefore examined the effect of prenatal treatments for common mental disorders on offspring outcomes.MethodsFor this meta-analysis, articles published up to August 31, 2017, were obtained from PubMed, PsycInfo, Embase, and Cochrane databases. Included studies needed to be randomized controlled trials (RCTs) on the effect of treatment of prenatal common mental disorders comparing an intervention to a control condition, including offspring outcome(s). Random effects models were used to calculate Hedges’ g in the program Comprehensive Meta-Analysis© (version 3.0).ResultsSixteen randomized controlled trials among 2778 pregnant women compared offspring outcomes between prenatal interventions and control groups. There were zero pharmacological, 13 psychological, and three other interventions (homeopathy, relaxation interventions, and short psycho-education). Birth weight (mean difference 42.88 g, g = 0.08, 95% CI −0.06 to 0.22, p = 0.27, n = 11), Apgar scores (g = 0.13, 95% CI −0.28 to 0.54, p = 0.53, n = 4), and gestational age (g = 0.03, 95% CI −0.06 to 0.54, p = 0.49, n = 10) were not significantly affected. Other offspring outcomes could not be meta-analyzed due to the inconsistent reporting of offspring outcomes and an insufficient number of studies.ConclusionsNon-pharmacological interventions had no significant effect on birth outcomes, although this outcome should be considered with caution due to the risk of biases. No randomized controlled trial examined the effects of prenatal pharmacological treatments as compared to treatment as usual for common mental disorders on offspring outcomes. Present clinical guidelines may require more research evidence on offspring outcomes, including child development, in order to warrant the current recommendation to routinely screen and subsequently treat prenatal common mental disorders.Trial registrationPROSPERO CRD42016047190Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1192-6) contains supplementary material, which is available to authorized users.

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A randomized controlled trial: effects of a prenatal depression intervention on perinatal outcomes among Chinese high-risk pregnant women with medically defined complications

Abstract: Chinese Clinical Trial Registry (ChiCTR-IOR-15006433), http://www.chictr.org.cn/enIndex.aspx (retrospectively registered).

Cited by 21 publications

References 38 publications

Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial

Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial

Impact of maternal mental health interventions on child-related outcomes in low- and middle-income countries: a systematic review and meta-analysis

Offspring outcomes after prenatal interventions for common mental disorders: a meta-analysis

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