Cited by 138Maternal Mental Health During Pregnancy and PostpartumPregnancy-related medical researchPersonality Disorders and Psychopathology

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Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis

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van Ravesteyn, Leontien M., Lambregtse - van den Berg, Mijke P., Hoogendijk, Witte J. G., Kamperman, Astrid M.·2017·PLOS ONE

DOI 10.1371/journal.pone.0173397PMC PMC5373816

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Abstract

BACKGROUND: For women suffering from an antepartum mental disorder (AMD), there is lack of evidence-based treatment algorithms due to the complicated risk-benefit analysis for both mother and unborn child. We aimed to provide a comprehensive overview of pharmacological and non-pharmacological interventions to treat AMD and performed a meta-analysis of the estimated treatment effect on the psychiatric symptoms during pregnancy. METHODS: MedLine, PsycINFO and Embase databases were searched by two independent reviewers for clinical trials with a control condition on treatment of women with AMD, i.e. major depressive (MDD), anxiety, psychotic, eating, somatoform and personality disorders. We inventoried the effect of the treatment, i.e. decrease of psychiatric symptoms at the end of the treatment or postpartum. We adhered to the PRISMA-protocol. FINDINGS: Twenty-nine trials were found involving 2779 patients. Trials studied patients with depressive disorders (k = 28), and anxiety disorders (k = 1). No pharmacological trials were detected. A form of psychotherapy, like Cognitive Behavioural Therapy (g = -0.61; 95%CI:-0.73 to -0.49, I2 = 0%; k = 7) or Interpersonal Psychotherapy (g = -0.67; 95%CI:-1.27 to -0.07; I2 = 79%; k = 4), holds robust benefit for pregnant women with MDD. Body-oriented interventions (g = -0.43; 95%CI:-0.61 to -0.25; I2 = 17%; k = 7) and acupuncture (g = -0.43; 95%CI:-0.80 to -0.06; I2 = 0%; k = 2) showed medium sized reduction of depressive symptoms. Bright light therapy (g = -0.59; 95%CI:-1.25 to 0.06; I2 = 0%; k = 2), and food supplements (g = -0.51; 95%CI:-1.02 to 0.01; I2 = 20%; k = 3) did not show significant treatment effects. One study was found on Integrative Collaborative Care. CONCLUSIONS: This meta-analysis found a robust moderate treatment effect of CBT for MDD during pregnancy, and to a lesser extent for IPT. As an alternative, positive results were found for body-oriented interventions and acupuncture. No evidence was found for bright light therapy and food supplements. Only non-pharmacological trials on women with MDD were found. Research on a wider range of AMD is needed.

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Fig 1 Flow diagram of the review selection procedure, adhered to the PRISMA statement.CC BY · PubMed Central

Fig 2 Funnel plot including pseudo 95% confidence limits of the included trials (k = 25) stratified by intervention.CC BY · PubMed Central

Fig 3 Hedges g of interventions to reduce depressive symptoms in pregnant women.CC BY · PubMed Central

Fig 4 Intervention effect in the full set of included trials (k = 25) using fixed and random estimation, and for different subgroups of trials. Pooled effect sizes for subgroups of trials are estimated using random-effects estimation. Fixed-effect estimation was used to compare differences over subgroups.CC BY · PubMed Central

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Authors: van Ravesteyn, L. M., Lambregtse - van den Berg, M. P., Hoogendijk, W. J. G., & Kamperman, A. M.
Affiliations: Erasmus MC (NL)
Corresponding author: Kamperman, Astrid M.
ORCID: van Ravesteyn, Leontien M.
Hoogendijk, Witte J. G.
Kamperman, Astrid M.
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2017-03-30
Volume: 12
Issue: 3
Pages: e0173397
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0173397
PMC: PMC5373816
OpenAlex: W2599194757
Semantic Scholar: 9d01af578d6ed04023e9ec64e63c387bd4d95122
Cited by: 138
References: 73
Citations by year: 2026: 7 · 2025: 10 · 2024: 12 · 2023: 16 · 2022: 17 · 2021: 27 · 2020: 20 · 2019: 14 · 2018: 13 · 2017: 2
FWCI: 2.17
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Funders: Erasmus University Medical Center (MRACE) (2008-8111)
Coolsingel Foundation (2009)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: antenatal depression, anxiety disorders in pregnancy, psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, body-oriented interventions, acupuncture, bright light therapy, dietary supplements, maternal mental health, postpartum outcomes, treatment algorithm, risk-benefit assessment, psychosis, eating disorders, somatoform disorders, personality disorders
MeSH terms: Adult, Anxiety Disorders, Depression, Female, Humans, Phototherapy, Pregnancy, Pregnancy Complications, Psychotherapy, Acupuncture Therapy, Cognitive Behavioral Therapy

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Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis

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