Effectiveness of psychological, psychoeducational and psychosocial interventions to prevent postpartum depression in adolescent and adult mothers: study protocol for a systematic review and meta-analysis of randomised controlled trials

Abstract

IntroductionThe prevalence of postpartum depression (PPD) is 17%, and the incidence is 12% worldwide. Adverse consequences for mothers and babies have been associated with this disease. To assess the effectiveness of psychological, psychoeducational and psychosocial interventions in preventing PPD, a systematic review and meta-analysis (SR/MA) will be conducted.Methods and analysisA SR/MA will be performed following the indications of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies will be identified through MEDLINE (Ovid and PubMed), PsycINFO, Web of Science, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, OpenGrey, Australian New Zealand Clinical Trial Registry, ClinicalTrials.gov and evidencebasedtherapy.org from inception until 31 January 2020. Bridging searches will be also conducted until the review is completed. The selection criteria will be as follows: (1) subjects will be pregnant females or females who have given birth in the last 12 months and who were non-depressive at baseline; (2) psychological, psychoeducational and psychosocial interventions; (3) comparator will be usual care, attention control, waiting list or no intervention; (4) outcomes will be specific results on PPD; and (5) the design of the studies will be randomised controlled trials. No restrictions regarding the year of publication, the setting of the intervention or the language of publication will be considered. Pooled standardised mean differences and 95% CIs will be calculated. The risk of bias of the studies will be assessed through the Cochrane Collaboration risk of bias tool. Heterogeneity between the studies will be determined by the I2 and Cochran’s Q statistics. Sensitivity and subgroup analyses will also be performed. Publication bias will be checked with funnel plots and Egger’s test. Heterogeneity will be explored by random-effects meta-regression analysis.Ethics and disseminationThe ethical assessment was not required. The results will be presented at conferences and disseminated through publications.PROSPERO registration numberCRD42018109981.

Impact of COVID-19 pandemic on mental health of young people and adults: a systematic review protocol of observational studies

“…Heterogeneity will also be tested by the I 2 statistic, which can quantify the heterogeneity ranging from 0% (no heterogeneity) to 100% (the differences between the effect sizes can completely be explained by chance alone), and the interpretations of the percentages are as follows: 0%–40% indicates potentially unimportant heterogeneity, 30%–60% indicates moderate heterogeneity, 50%–90% indicates substantial heterogeneity and 75%–100% indicates considerable heterogeneity. 35 To explore the heterogeneity across studies, subgroup analysis will be performed using a mixed effects model according to the following variables: age (young people vs adults), ethnicity (impact on mental health of patients from a specific ethnic group vs not) and psychological distress (mild vs moderate vs severe).…”

“…Statistical analyses will be carried out using the Statistical Package for the Social Sciences (SPSS), V.18.0 (SPSS). Standardised mean differences (SMDs) and 95% CI will be used to calculate the effect sizes, as we expect that most of the observational studies 35 included in our meta-analysis have reported differences in psychological symptoms. All effect sizes will be transformed into a common metric in order to make them comparable across studies-the biascorrected standardised difference in means (Hedges' g).…”

“…Heterogeneity will also be tested by the I 2 statistic, which can quantify the heterogeneity ranging from 0% (no heterogeneity) to 100% (the differences between the effect sizes can completely be explained by chance alone), and the interpretations of the percentages are as follows: 0%-40% indicates potentially unimportant heterogeneity, 30%-60% indicates moderate heterogeneity, 50%-90% indicates substantial heterogeneity and 75%-100% indicates considerable heterogeneity. 35 Open access…”

Eficacia de las intervenciones no farmacológicas en la prevención de la depresión posparto: una revisión sistemática de los resultados en gestantes con y sin factores de riesgo

“…Los síntomas más comunes de la depresión posparto son el estado de ánimo triste, dificultad para concentrarse, fatiga, falta de interés por el bebé, sentimiento de ser una mala madre, insomnio, miedo a lastimarse a sí misma o al bebé y pérdida de interés o placer en la vida 13 . Se han descrito también llanto frecuente, falta de apetito, síntomas somáticos múltiples, incapacidad para afrontar situaciones estresantes, baja autoestima e ideación suicida 14 .…”

“…Una forma de reducir la carga de enfermedad que provoca la depresión es disminuir la incidencia de nuevos casos, objetivo que puede lograrse mediante intervenciones preventivas 13 , que implican el tratamiento de un gran número de mujeres de la población general que pueden no estar en riesgo o que involucran a población de alto riesgo 31 . La mayoría de las terapias preventivas disponibles se basan en enfoques no farmacológicos de tipo psicológicos, psicoeducativos, psicosociales y físicos 13,32 .…”