Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada.
Department of Obstetrics and Gynecology, HSC-3N52D, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
BMC Pregnancy Childbirth. 2021 Jan 6;21(1):18. doi: 10.1186/s12884-020-03496-5.
Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions.
An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD.
Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, - 0.09 to 0.34), or source of funding (p = 0.19).
Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.
产后抑郁症（PPD）是一种高发的心理健康问题，会影响父母的健康，进而对婴儿、儿童、青少年及以后的儿童健康产生影响。本研究的主要目的是批判性地评估描述 PPD 干预措施的现有系统评价。次要目的是评估纳入的系统评价及其结论的方法学质量。
对 2000 年至 2020 年期间 MEDLINE、Embase 和 Cochrane 图书馆的电子数据库进行了搜索，以确定评估 PPD 干预措施的系统评价。使用评估系统评价的测量工具（Measurement Tool to Assess Systematic Reviews）对每个纳入的系统评价进行独立评分，然后进行批判性评估，以更好地确定 PPD 的最有效治疗选择。
在确定的 842 项研究中，有 83 项符合预先设定的纳入标准。根据方法学质量最高的系统评价，我们发现使用抗抑郁药和远程医疗是治疗 PPD 最有效的方法。传统草药和芳香疗法也能改善 PPD 的症状。目前，关于体育锻炼和认知行为疗法治疗 PPD 的证据仍然存在争议。观察到 AMSTAR 评分与期刊影响因子之间存在显著但较弱的关系（p=0.03，r=0.24；95%CI，0.02 至 0.43），而总引文数（p=0.27，r=0.12；95%CI，-0.09 至 0.34）或资金来源（p=0.19）之间没有关系。
总体而言，针对 PPD 干预措施的系统评价质量较低，且并未随时间改善。抗抑郁药和远程医疗是治疗 PPD 的最有效治疗干预措施。
