Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis

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Abstract

Background

Postpartum depression (PPD) is a prevalent mental health problem with serious adverse consequences for affected women and their infants. Clinical trials have found that telehealth interventions for women with PPD result in increased accessibility and improved treatment effectiveness. However, no comprehensive synthesis of evidence from clinical trials by systematic review has been conducted.

Objective

The aim of this study is to evaluate the effectiveness of telehealth interventions in reducing depressive symptoms and anxiety in women with PPD. To enhance the homogeneity and interpretability of the findings, this systematic review focuses on PPD measured by the Edinburgh Postnatal Depression Scale (EPDS).

Methods

PubMed, The Cochrane Library, CINAHL, PsycINFO, CNKI, and Wanfang were electronically searched to identify randomized controlled trials (RCTs) on the effectiveness of telehealth interventions for women with PPD from inception to February 28, 2021. Data extraction and quality assessment were performed independently by two researchers. The quality of included studies was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using RevMan 5.4 software.

Results

Following the search, 9 RCTs with a total of 1958 women with PPD were included. The EPDS (mean difference=–2.99, 95% CI –4.52 to –1.46; P<.001) and anxiety (standardized mean difference=–0.39, 95% CI –0.67 to –0.12; P=.005) scores were significantly lower in the telehealth group compared with the control group. Significant subgroup differences were found in depressive symptoms according to the severity of PPD, telehealth technology, specific therapy, and follow-up time ( P<.001).

Conclusions

Telehealth interventions could effectively reduce the symptoms of depression and anxiety in women with PPD. However, better designed and more rigorous large-scale RCTs targeting specific therapies are needed to further explore the potential of telehealth interventions for PPD.

Trial Registration

PROSPERO CRD42021258541; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258541

Related collections

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Author and article information

Contributors

Ri-hua Xie:

ORCID: https://orcid.org/0000-0002-3023-5412

Department of NursingThe Seventh Affiliated HospitalSouthern Medical University28 Liguan Road, LishuiFoshan, 528244China86 189 2869 7126xierihua928@hotmail.com

Journal

Journal ID (nlm-ta): JMIR Mhealth Uhealth

Journal ID (iso-abbrev): JMIR Mhealth Uhealth

Journal ID (publisher-id): JMU

Title: JMIR mHealth and uHealth

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2291-5222

Publication date Collection: October 2021

Publication date (Electronic): 7 October 2021

Volume: 9

Issue: 10

Electronic Location Identifier: e32544

Affiliations

[1 ] Department of Nursing The Seventh Affiliated Hospital Southern Medical University Foshan China

[2 ] Department of Obstetrics and Gynecology The Seventh Affiliated Hospital Southern Medical University Foshan China

[3 ] Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa, ON Canada

[4 ] Department of Nursing The Affiliated Hospital of Guangdong Medical University Zhanjiang China

[5 ] Department of Obstetrics & Gynecology Faculty of Medicine University of Ottawa Ottawa, ON Canada

[6 ] School of Epidemiology and Public Health Faculty of Medicine University of Ottawa Ottawa, ON Canada

Author notes

Corresponding Author: Ri-hua Xie xierihua928@ 123456hotmail.com

Author information

Liuhong Zhao https://orcid.org/0000-0003-3826-6341

Jingfen Chen https://orcid.org/0000-0002-1507-4307

Liuying Lan https://orcid.org/0000-0003-3458-3016

Ni Deng https://orcid.org/0000-0002-1817-9737

Yan Liao https://orcid.org/0000-0002-8584-7467

Liqun Yue https://orcid.org/0000-0002-1240-194X

Innie Chen https://orcid.org/0000-0002-6389-4617

Shi Wu Wen https://orcid.org/0000-0002-7227-0283

Ri-hua Xie https://orcid.org/0000-0002-3023-5412

Article

Publisher ID: v9i10e32544

DOI: 10.2196/32544

PMC ID: 8532017

PubMed ID: 34617909

SO-VID: 6b4f8184-0086-4d2f-8ed7-583742d28484

Copyright © ©Liuhong Zhao, Jingfen Chen, Liuying Lan, Ni Deng, Yan Liao, Liqun Yue, Innie Chen, Shi Wu Wen, Ri-hua Xie. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 07.10.2021.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 1 August 2021

Date revision requested : 29 August 2021

Date revision received : 5 September 2021

Date accepted : 17 September 2021

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