2002 International International Biennial Scientific Meeting

THE PREVENTION OF POSTNATAL DEPRESSION: A QUALITATIVE SYSTEMATIC REVIEW

Elizabeth Boath, Eleanor Bradley and Carol Henshaw

Centre for Health Policy and Practice, School of Health, Staffordshire University, UK

e.boath@staffs.ac.uk

Objectives: This qualitative systematic review was designed to evaluate the success of preventative interventions for postnatal depression and to establish whether current interventions effectively prevent postnatal depression.

Methods: Systematic review of randomised controlled trials.

Data sources: Electronic databases Medline, Psychlit, Sociofile, CINAHL, COPAC, EMBASE, Cochrane library; systematic follow-up of reference lists and hand searches. Newsletter request for unpublished trials to members of the Marce Society.

Study selection: Trials of preventative interventions for postnatal depression. Outcomes examined were estimates of postnatal depression prevalence. Methodological quality was determined through the examination of key components individually.

Data extraction: Independent data extraction by all three authors using data extraction sheets.

Results: 20 articles containing original data related to the prevention of postnatal depression were identified, 10 of which were excluded. Of the 10 included trials (2319 patients), 1 trial described a hormonal intervention, 7 trials described psychological and supportive interventions, 1 trial described an antidepressant intervention, and 1 trial described an intervention administering calcium. 3 of the psychological interventions suggested short-term preventative success, however the lack of methodological rigour in these studies means that the results must be viewed with caution. The trials evaluating hormonal, antidepressant and calcium interventions were unsuccessful in preventing postnatal depression.

Conclusions: There is no evidence to suggest the prevention of postnatal depression is effective. The failure of preventative interventions may be due to methodological limitations thus further valid randomised controlled studies are needed. Failure may also be accounted by the restriction of current preventative interventions to a single factor approach.