Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
Neuropsychopharmacol Rep. 2021 Mar;41(1):2-13. doi: 10.1002/npr2.12155. Epub 2020 Dec 19.
This systematic review aimed to evaluate randomized controlled trials (RCTs) to examine the effect of maternal and infant sleep intervention during women's pregnancy for the purpose of preventing perinatal depression.
A systematic search (from inception to January 28, 2019) for RCTs using five electronic databases-the Cochrane Controlled Register of Trials (CENTRAL), Embase, PubMed, PsycINFO, and Ichushi Web (Japan Medical Abstracts Society)-was conducted. Twelve investigators independently conducted initial screenings based on title and abstract, and then, two researchers performed full-text reviews one by one. A meta-analysis would be conducted if at least three studies were found. However, only two articles that met inclusion criteria, and narrative data synthesis was conducted for these two articles. The study protocol has been registered at PROSPERO (CRD42019119999).
A total of 13 654 studies were initially searched. After removing duplicates, 10 547 studies were screened, and finally, two studies met the inclusion criteria. In both studies, the intervention was a one-time face-to-face session during pregnancy to deliver the behavioral knowledge and skills for optimizing sleep hygiene for both infant and mother. Effectiveness of the intervention in improving maternal mood was not significant in one study. In the other, there was a significant difference in maternal mood between the intervention and control group. No mood comparison was made between baseline and postintervention.
This study found limited evidence to support the effectiveness of sleep intervention for all pregnant women, which means "universal intervention," to protect maternal mental health. Further well-designed RCTs are needed to confirm these findings.
本系统评价旨在评估随机对照试验(RCT),以考察针对孕妇的母婴睡眠干预对预防围产期抑郁的效果。
从建库至 2019 年 1 月 28 日,我们使用五个电子数据库(Cochrane 对照试验注册库(CENTRAL)、Embase、PubMed、PsycINFO 和 Ichushi Web(日本医学文摘协会))对 RCT 进行了系统检索。12 名调查员根据标题和摘要进行了初步筛选,然后由两名研究人员逐一进行了全文审查。如果至少发现三项研究,将进行荟萃分析。但是,仅发现了两篇符合纳入标准的文章,因此对这两篇文章进行了叙述性数据综合。该研究方案已在 PROSPERO(CRD42019119999)上注册。
共检索到 13654 项研究。剔除重复后,筛选出 10547 项研究,最终有两项研究符合纳入标准。在这两项研究中,干预措施均为在孕期进行一次面对面的课程,向母婴传授优化睡眠卫生的行为知识和技能。一项研究中,干预对改善产妇情绪的效果不显著。另一项研究中,干预组和对照组的产妇情绪存在显著差异。两项研究均未对干预前后的情绪进行比较。
本研究发现,支持针对所有孕妇开展睡眠干预以保护产妇心理健康的“普遍干预”措施有效证据有限。需要进一步设计良好的 RCT 来证实这些发现。