CAPHRI, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands.
CAPHRI, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands.
Midwifery. 2021 Mar;94:102906. doi: 10.1016/j.midw.2020.102906. Epub 2020 Dec 19.
Postpartum depression, one of the most common forms of depression, is highly prevalent worldwide among women during childbirth. Despite available treatments for postpartum depression, numerous barriers hinder women to access care including time, financial constraints, and childcare concerns. Telemedicine interventions are suggested to be feasible to prevent and improve postpartum depression.
To examine the effectiveness of telemedicine interventions - delivered exclusively during the postnatal period, on postpartum depression symptomatology in women with no history of mental disorders.
A systematic review and meta-analysis of randomized controlled trials.
PubMed, Web of Science, Cochrane Library, and ProQuest Dissertations & Theses databases were used to identify relevant randomized controlled trials, until 7 January 2020. Studies were quality assessed using the Cochrane Library Risk of Bias Tool. The results of postpartum depression scores were pooled using a random-effects model. Intervention completion rate and participants' satisfaction were reported in a narrative form, as secondary outcomes.
Ten trials including a total of 2366 participants, contributed data to the review. Seven studies were included in the quantitative synthesis. Women who received technology-based interventions, regardless of the type (web-based versus telephone-based), had a statistically significant improvement in postpartum depression (mean difference: -1.81, 95% CI: -2.68 to -0.93; P<.0001). The completion rate was 80% in the intervention groups compared to 76% in the control groups. Three studies reporting participants' satisfaction revealed that the participants were highly satisfied with the technology-based interventions.
Overall, telemedicine interventions appear to be promising in preventing and improving postpartum depression. Further larger-scale high-quality research is required to establish an evidence-based telemedicine approach, in terms of structure, content, and providers. Future economic evaluation is also vital to evaluate the long-term use of telemedicine in improving postpartum depression.
产后抑郁症是最常见的抑郁症之一，在全球范围内，分娩后的女性中发病率很高。尽管有针对产后抑郁症的治疗方法，但许多障碍使女性难以获得治疗，包括时间、经济限制和儿童保育问题。远程医疗干预措施被认为可以预防和改善产后抑郁症。
研究专门在产后期间提供的远程医疗干预措施对无精神障碍病史的女性产后抑郁症症状的效果。
系统评价和荟萃分析的随机对照试验。
使用 PubMed、Web of Science、Cochrane 图书馆和 ProQuest 论文和论文数据库，直到 2020 年 1 月 7 日，以确定相关的随机对照试验。使用 Cochrane 图书馆偏倚风险工具对研究进行质量评估。使用随机效应模型汇总产后抑郁评分的结果。干预完成率和参与者满意度以叙述形式报告，作为次要结果。
10 项试验共纳入 2366 名参与者，为综述提供了数据。7 项研究被纳入定量综合分析。接受基于技术的干预措施的女性，无论类型（基于网络与基于电话）如何，产后抑郁症均有统计学显著改善（平均差异：-1.81，95%CI：-2.68 至-0.93；P<.0001）。干预组的完成率为 80%，而对照组为 76%。三项报告参与者满意度的研究表明，参与者对基于技术的干预措施非常满意。
总体而言，远程医疗干预措施似乎有望预防和改善产后抑郁症。需要进一步开展更大规模、高质量的研究，以确定基于证据的远程医疗方法，包括结构、内容和提供者。未来的经济评估对于评估远程医疗在改善产后抑郁症方面的长期使用也至关重要。
