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Cited by 75Maternal Mental Health During Pregnancy and PostpartumDigital Mental Health InterventionsTelemedicine and Telehealth Implementation

The effectiveness of telemedicine interventions, delivered exclusively during the postnatal period, on postpartum depression in mothers without history or existing mental disorders: a systematic review and meta-analysis

Open access
Hanach, Nivine, de Vries, Nanne, Radwan, Hadia, Bissani, Nour·2021·Midwifery
DOI 10.1016/j.midw.2020.102906
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Abstract

BACKGROUND: 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. OBJECTIVE: 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. DESIGN: A systematic review and meta-analysis of randomized controlled trials. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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  • IMIs have shown efficacy in significantly improving depressive symptoms in peripartum women.

    “IMIs have also shown efficacy in significantly improving depressive symptoms in peripartum women (e.g., Duffecy et al., 2022; Hanach et al., 2021; Lau et al., 2021; Loughnan et al., 2019; Mu et al., 2021).”

    From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Hanach et al., 2021

    The Postpartum Depression results report a significant reduction in depressive-symptom scores, and the Discussion describes favourable effects of telemedicine interventions. But the review concerns interventions delivered exclusively after birth, not throughout the peripartum period; its Intervention section also includes telephone support alongside internet- and mobile-based approaches. (LLM, conf=0.85)

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  • Some studies failed to show efficacy and/or long-term effectiveness of self-help interventions treating PPD.

    “However, some studies failed to show efficacy and/or long-term effectiveness of self-help interventions treating PPD (Hanach et al., 2021; Lin et al., 2018).”

    From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Hanach et al., 2021

    The Follow-up section reports that some postnatal telemedicine studies found no statistically significant improvement at six or twelve months, supporting the point about uncertain long-term effectiveness. But the Intervention section describes telephone, web, app, and social-media programs, often delivered or supported by trained personnel; it does not establish that the studies with these findings tested self-help interventions specifically. Page numbers are unavailable in our copy. (LLM, conf=0.85)

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  • Peripartum specific IMIs have proven to be feasible and acceptable.

    “Additionally, these interventions have proven to be feasible and acceptable (Fonseca et al., 2020; Forsell et al., 2017; Hanach et al., 2021; Loughnan et al., 2019)”

    From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Hanach et al., 2021

    The Conclusion reports that telemedicine interventions were feasible and acceptable among mothers in the postnatal period, and the Discussion describes acceptance of web-based interventions. The review covers postnatal interventions only and includes telephone-based approaches, so it does not establish the claim for peripartum internet- and mobile-based interventions generally. No page number was available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • There are currently few systematic reviews and meta-analyses specifically on mental health and telemedicine interventions for pregnant women or new mothers.

    “To our knowledge, there are currently few systematic reviews and meta-analyses in the literature that have dealt specifically with the topic of mental health and telemedicine interventions for pregnant women or new mothers [26–31].”

    From Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review (2023) · cites this paper as [30]

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Cites

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2 of the 40 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Dennis, C.-.L. , 2003. In: Stewart, D.E., Robertson, E., Dennis, C.-L., Grace, S.L., Walling- ton, T. (Eds.). Postpartum depression: Literature review of risk factors and interven- tions .
  2. Higgins, J.P. , Thomas, J. , Chandler, J. , Cumpston, M. , Li, T. , Page, M.J. , 2019. In: Welch, V.A. (Ed.), eds.. John Wiley & Sons .

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Authors
Hanach, N., de Vries, N., Radwan, H., & Bissani, N.
Affiliations
  • Maastricht University (NL)
  • University of Sharjah (AE)
  • American University of Beirut (LB)
Corresponding author
Hanach, Nivine
ORCID
Venue
Midwifery
Publisher
Elsevier BV
Published
2021-03
Volume
94
Pages
102906
ISSN
0266-6138 (ISSN-L)
DOI
10.1016/j.midw.2020.102906
OpenAlex
W3117962858
Cited by
75
References
40
Citations by year
2026: 10 · 2025: 8 · 2024: 18 · 2023: 26 · 2022: 9 · 2021: 4
FWCI
1.63
Type
journal article
Language
en
Open access
Licence
Locations
  • Midwifery (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
postpartum depression, telemedicine, postpartum period, online intervention, telephone-delivered intervention, technology-based interventions, maternal mental health, participant satisfaction, access to mental health care
MeSH terms
Female, Humans, Mothers, Pregnancy, Telephone, Telemedicine, Depression, Postpartum, Parturition

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