de-Juan-Iglesias Paula, Gómez-Gómez Irene, Barquero-Jimenez Carlos, Wilson Claire A, Motrico Emma
Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen del Rocío, CSIC, University of Seville, Spain.
Department of Developmental and Educational Psychology, Universidad de Sevilla, Spain.
Internet Interv. 2024 Jul 18;37:100759. doi: 10.1016/j.invent.2024.100759. eCollection 2024 Sep.
Little is known about the effectiveness of online preventive interventions for paternal perinatal depression (PPD). This systematic review (SR) and meta-analysis (MA) of randomized controlled trials (RCTs) evaluated the effectiveness of online psychological interventions to prevent PPD in fathers and non-birthing partners. The PRISMA 2020 guidelines were followed. The search was conducted in eight electronic databases and other sources from inception to 12 May 2023. The pooled standardized mean difference (SMD) was computed using random-effect models. Seven RCTs were included in the SR and 6 were included in the MA, representing 1.042 fathers from five different countries. No trials focused on non-birthing partners were found. The pooled SMD was -0.258 [95 % confidence interval - 0.513 to -0.004; < 0.047]. The heterogeneity was moderate (I2 = 51 %; 95%CI [0 % to 81 %]) and nonsignificant ( = 0.070). However, sensitivity analyses showed that the effectiveness was stable only when the fixed effect model and the Egger's g were used to estimate the pooled SMD. No publication bias was found. Only two RCTs had an overall low risk of bias assessed by using the Cochrane ROB 2.0 tool. The quality of evidence based on GRADE was very low. In conclusion, online psychological interventions may be effective for the prevention of PPD. More high-quality evidence is warranted.
关于在线预防性干预对父亲围产期抑郁症（PPD）的有效性知之甚少。这项对随机对照试验（RCT）的系统评价（SR）和荟萃分析（MA）评估了在线心理干预对预防父亲和非分娩伴侣患PPD的有效性。遵循了PRISMA 2020指南。从数据库建立至2023年5月12日，在八个电子数据库和其他来源中进行了检索。使用随机效应模型计算合并标准化均数差（SMD）。SR纳入了7项RCT，MA纳入了6项，代表来自五个不同国家的1042名父亲。未发现针对非分娩伴侣的试验。合并SMD为-0.258 [95%置信区间 -0.513至-0.004；P<0.047]。异质性为中度（I2 = 51%；95%CI [0%至81%]）且无显著性（P = 0.070）。然而，敏感性分析表明，仅当使用固定效应模型和Egger检验来估计合并SMD时，有效性才稳定。未发现发表偏倚。使用Cochrane ROB 2.0工具评估，只有两项RCT的总体偏倚风险较低。基于GRADE的证据质量非常低。总之，在线心理干预可能对预防PPD有效。需要更多高质量的证据。
