Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis (Preprint)

Abstract

BACKGROUND Background: Postpartum depression is a highly prevalent mental health problem with potential for serious adverse consequences. Telehealth interventions can increase the accessibility to treatments for postpartum depression and their effectiveness has been assessed by clinical trials. However, no comprehensive synthesis of findings by systematic review has been conducted. OBJECTIVE Objective: To evaluate the effectiveness of telehealth interventions on women with postpartum depression in terms of reducing depressive symptoms, anxiety and loneliness, and improving social support. METHODS Methods: PubMed, The Cochrane Library, CINAHL, PsycINFO, CNKI, and Wan Fang database were electronically searched to identify studies with randomized controlled trials (RCTs) on the effectiveness of telehealth interventions on women with postpartum depression from inception to February 28, 2021. Data extraction and quality assessment were performed by two researchers independently. The quality of included studies was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using RevMan 5.4 software. RESULTS Results: A total of 1,958 women with postpartum depression from nine RCTs were included. The meta-analysis showed that the scores of Edinburgh Postnatal Depression Scale (EPDS) [MD=-2.99, 95%CI (-4.52, -1.46), P<.001] and anxiety [SMD=-0.39, 95%CI (-0.67, -0.12), P=.005] were significantly lower in the telehealth group compared with the control group. No significant differences were observed for social support and loneliness. Significant subgroup differences were found for depressive symptoms according to the severity of postpartum depression, telehealth technology used, specific therapy, and follow up time periods (P<.001). CONCLUSIONS Conclusions: Telehealth interventions are effective in reducing depression and anxiety in women with postpartum depression. However, large scale RCTs targeting specific therapies in women are needed to help tailor treatment strategies to individuals. CLINICALTRIAL PROSPERO CRD42021258541; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258541