Materiały źródłowe

• #1 Essential Reads: Strategies for the Prevention of Postpartum Depression – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/prevention-of-postpartum-depression-2/

  Postpartum depression (PPD) is a relatively common problem, affecting between 10% and 15% of women after delivery. […] In 2019, the US Preventive Services Task Force (USPSTF) issued recommendations that all pregnant and postpartum women should be evaluated in order to determine risk for depressive illness and recommended that women at increased risk should be referred for counseling interventions. Ultimately the goal is to identify women at highest risk for depressive illness during pregnancy and the postpartum period, so that we can introduce interventions designed to prevent depression in this setting. […] Based on this review of the literature, the USPSTF found convincing evidence to support the use of counseling interventions, specifically those using cognitive behavioral therapy and interpersonal therapy, as an effective means of preventing perinatal depression.

• #2 Interventions for the Prevention of Postpartum Depression – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/interventions-for-the-prevention-of-postpartum-depression/

  Postpartum depression (PPD) is a relatively common problem, affecting between 10% and 15% of women after delivery. […] The big question is: What can we do to reduce the risk of PPD in women at risk? […] In a group of women with histories of postpartum depression, Wisner and colleagues described a beneficial effect of prophylactic treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant. […] Other studies have explored the potential efficacy of non-pharmacologic interventions in these populations of women at risk. […] The PREPP intervention also provided (1) supportive psychological interviewing that encouraged exploration of the mother’s childhood and how it informs parental identity, (2) psychoeducation about the postpartum period, and (3) various mindfulness techniques aimed at helping mothers to cope better when their babies are distressed and/or unsoothable.

• #3 Rose Program | Postpartum Depression Care | Women & Infants Hospital

  https://www.womenandinfants.org/rose-program-postpartum-depression

  Postpartum depression is a common public health problem with serious and lasting consequences for mother and child, especially among low-income women. Maternal mental health is a critical component of perinatal care and maternal safety. […] The ROSE Program (Reach Out, Stay Strong, Essentials for mothers of newborns) is an evidence-based program that has been shown to reduce cases of postpartum depression by half among low-income women in a series of randomized control trials. […] The ROSE Program has been specifically cited in the new U.S. Preventive Services Task Force recommendation regarding the prevention of perinatal depression. […] The intervention is highly structured, easy to learn, and can be delivered in both Spanish and English. Nurses, health educators, and others with or without mental health expertise can successfully provide ROSE.

• #4 Can you prevent postpartum depression? Strategies to reduce your risk

  https://www.talkiatry.com/blog/how-to-avoid-postpartum-depression

  Postpartum depression can be daunting, but understanding the risk factors and treatment options can help you manage PPD or avoid it. […] New mothers often feel that PPD is a character flaw or caused by something they did either during pregnancy or after delivery. Its important to remember that any new mom can experience PPD and while theres nothing you can do to prevent it, there are things you can do to reduce your risk. […] While you cant prevent postpartum depression, or any other mental health condition for that matter, there are things you can do to reduce your risk. […] Most of the focus during your doctors appointments will be on your growing belly, but your mental health is also an important part of pre and postnatal care. […] If its an option for you, reach out to your partner, family members, or friends who will be there to support you in the postpartum period.

• #5 Postpartum Depression: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression

  Postpartum depression isn’t entirely preventable. It helps to know warning signs of the condition and what factors increase your risk. Here are some tips that can help prevent postpartum depression: […] Be realistic about your expectations for yourself and your baby […] Limit visitors when you first go home […] Ask for help let others know how they can help you […] Sleep or rest when your baby sleeps […] Exercise take a walk and get out of the house for a break […] Keep in touch with your family and friends don’t isolate yourself […] Foster your relationship with your partner make time for each other […] Expect some good days and some bad days.

• #6 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Women at high risk for postpartum illness should be identified before delivery. This includes women with a previous episode of postpartum illness and women with a history of either unipolar or bipolar depression. Women who experience depression during pregnancy should also be considered at high risk for postpartum illness. […] In addition to monitoring, women with a history of recurrent depression or a history of postpartum depression may benefit from prophylactic treatment with an antidepressant medication. If antidepressants are not used during pregnancy, they may be initiated shortly before or immediately after delivery to reduce the risk of recurrent illness. […] Women with bipolar disorder or a history of postpartum psychosis may benefit from prophylactic treatment with lithium, initiated either before or within 24 hours of delivery. […] The prophylactic efficacy of nonpharmacologic interventions in this setting has not been fully assessed, although one study reported lower rates of postpartum depression in a group of women receiving interpersonal therapy for depression during pregnancy.

• #7 Recommendation: Perinatal Depression: Preventive Interventions | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/perinatal-depression-preventive-interventions

  A pragmatic approach, based on the populations included in the systematic evidence review, would be to provide counseling interventions to women with 1 or more of the following: a history of depression, current depressive symptoms (that do not reach a diagnostic threshold), certain socioeconomic risk factors such as low income or adolescent or single parenthood, recent intimate partner violence, or mental health-related factors such as elevated anxiety symptoms or a history of significant negative life events. […] The USPSTF found limited or mixed evidence that other studied interventions such as physical activity, education, pharmacotherapy, dietary supplements, and health system interventions were effective in preventing perinatal depression. […] The USPSTF found adequate evidence to bound the potential harms of counseling interventions as no greater than small, based on the nature of the interventions and the low likelihood of serious harms.

• #8 Prevention of Postpartum Depression by Multidisciplinary Collaboration in Japan | JMA Journal

  https://www.jmaj.jp/detail.php?id=10.31662%2Fjmaj.2024-0070

  The ultimate goal of measures for maternal mental disorders is to support a healthy child-rearing environment through the provision of appropriate support for the unstable and vulnerable changes in the mothers mind. […] It is also known that multidisciplinary support through a high risk approach, including local administration for breastfeeding and daily living in the field of obstetrics, is effective for mild cases, which account for a large proportion of these cases. […] However, the timing of onset is characteristic, such as early pregnancy and early postpartum, and risk factors such as unexpected pregnancy, strong anxiety regarding pregnancy, history of mental disorder, lack of support, and unstable family situation have been identified to some extent. […] Moreover, more than half of women who develop postpartum depression exhibit depressive symptoms during pregnancy, and there is evidence proving that intervention and support during pregnancy can prevent the onset and severity of postpartum depression by identifying the high risk groups.

• #9 Recommendation: Perinatal Depression: Preventive Interventions | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/perinatal-depression-preventive-interventions

  Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions. […] Provide or refer persons at increased risk of perinatal depression to counseling interventions. […] The USPSTF found convincing evidence that counseling interventions, such as cognitive behavioral therapy and interpersonal therapy, are effective in preventing perinatal depression in those at increased risk. […] The USPSTF concludes with moderate certainty that counseling interventions to prevent perinatal depression have a moderate net benefit for persons at increased risk.

• #10 Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018 | MMWR

  https://www.cdc.gov/mmwr/volumes/69/wr/mm6919a2.htm

  Perinatal depression is a complication of pregnancy associated with poor maternal and infant health outcomes. Universal screening of pregnant and postpartum women for depression is recommended. […] Health care provider screening of all women in the perinatal period can increase identification of women at risk for depression and provision of care or referral for appropriate diagnosis and treatment. […] Screening to identify pregnant and postpartum women with depressive symptoms is recommended to provide diagnosis, treatment, and follow-up care to reduce poor outcomes. […] Provision of recommended screenings and appropriate referrals for diagnosis, treatment, and follow-up care can ensure early and effective management of depression to reduce adverse maternal and infant outcomes. […] Identifying women with PDS should be complemented with adequate systems to ensure needed diagnosis, treatment, and follow-up.

• #11 Current recommendations for screening and management of postpartum depression – Women’s Healthcare

  https://www.npwomenshealthcare.com/current-recommendations-for-screening-and-management-of-postpartum-depression/

  Postpartum depression is one of the most common disorders of the peripartum period and has significant adverse effects on the mother and infant. […] Several organizations, including ACOG, American Association of Family Practice, and the Centers for Disease Control and Prevention recommend antenatal screening of all pregnant patients. […] Another method for preventing postpartum depression is antenatal counseling. […] The USPSTF determined that there is a moderate benefit to counseling for pregnant women, specifically for those women who are identified as being at risk for postpartum depression. […] The use of cognitive-behavioral therapy is even more effective when the patients partner participates in therapy. […] Early identification and treatment of antepartum depression is recommended to reduce the incidence of postpartum depression.

• #12 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  Prevention of perinatal depression in high-risk patients using counseling and cognitive behavioral therapy, as well as interpersonal therapy, has been effective. Clinicians should identify and implement these interventions as preventative measures for high-risk patients. […] Screening for perinatal depression should be a routine part of prenatal and postpartum care, utilizing tools such as the Edinburgh Postnatal Depression Scale (EPDS) to identify those at risk. Treatment typically involves a combination of psychotherapy, support groups, and medication, including antidepressants, which can safely be used during pregnancy and lactation. […] By increasing awareness, new mothers can recognize the onset of perinatal depression early and seek timely intervention. Education programs can include prenatal classes, informational brochures, and discussions during regular medical appointments. Additionally, integrating mental health screenings into antepartum and postpartum checkups can help with early detection and management. […] Effective interprofessional communication and care coordination among clinicians are essential in identifying, monitoring, and treating perinatal depression, ultimately improving patient outcomes and safety.

• #13 ‘Next Stop: Mum’: Evaluation of a Postpartum Depression Prevention Strategy in Poland

  https://www.mdpi.com/1660-4601/19/18/11731

  The research study was based on the ‘Next Stop: Mum’ PPD preventive program. […] The ‘Next Stop: Mum’ project covers 37 primary healthcare centers and 7 state hospitals. Medical staff working from the collaborating centers and hospitals obtain 6-h training concerning mental health in the perinatal period and screening methods. […] Patients using the care of cooperating primary health centers and hospitals receive leaflets containing information on mental health in the postpartum period. […] A vital element of the website is an online version of the Edinburgh Postnatal Depression Scale, which enables anonymous self-screening and the possibility of receiving immediate feedback (with suggestions for further steps to be taken, e.g., contact with a psychologist). […] Screening for PPD is provided with EPDS. […] Women who obtain results defined as ‘probable depression’ (12 points or above) or subclinical, possible PDD (10–11 points) results in the EPDS assessment have an opportunity to participate in free-of-cost three psychological consultations.

• #14 Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018 | MMWR

  https://www.cdc.gov/mmwr/volumes/69/wr/mm6919a2.htm

  Health care providers can provide timely perinatal depression education to women and family members or other support persons. Health systems can implement quality improvement through screening and linkage to care for depression during both the prenatal and postpartum periods. […] Screening for perinatal depression should be accompanied by evidence-based systems for diagnosis, counseling, treatment, and referral.

• #15 Psychological intervention for universal prevention of antenatal and postnatal depression among pregnant women: protocol for a systematic review and meta-analysis | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-1238-7

  Prevention of antenatal and postnatal depression is crucial, given its high prevalence and severe consequences. […] The aim of this study is to examine the effects of psychological interventions with a universal prevention focus on perinatal depression during pregnancy by performing a systematic review and meta-analysis based on both the latest articles and a broader literature search. […] In a previous systematic review and meta-analysis, psychological interventions were recommended as the most effective approach to prevent antenatal and postnatal depression, especially among individuals with risk factors, such as a history of depression, lack of social support, and unwanted pregnancies. […] Among psychological interventions, cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) have been widely studied and found to be highly effective.

• #16 Preventing Postpartum Depression Closer to Home | PCORI

  https://www.pcori.org/impact/pcori-stories/preventing-postpartum-depression-closer-home

  A PCORI-funded study compares the effectiveness of prevention programs led by lay home visitors and mental health professionals that teach mothers-to-be the skills to improve their moods and bond with their babies. […] Her home visiting nurse referred her to Mothers and Babies, a program for preventing postpartum depression and the focus of a PCORI-funded study. […] The task force found that for those patients, interventions, such as cognitive behavioral therapy, can effectively prevent perinatal depression. […] At its core, Mothers and Babies is a group-based program relying on cognitive behavioral therapy and attachment theory, a combination designed to provide expectant moms the tools for changing thought patterns, improving mood, and bonding with their babies to prevent postpartum depression.

• #17 Retention rates and potential predictors in a longitudinal randomized control trial to prevent postpartum depression

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252010000500007

  Retention rates and potential predictors in a longitudinal randomized control trial to prevent postpartum depression. […] Perinatal depression is increasingly recognized as a significant public mental health problem; consequently, there is a major interest in developing strategies to prevent postpartum depression that may help reduce its detrimental consequences. […] The aim of the study is to examine retention rates and predictors of retention in a longitudinal, randomized controlled trial (RCT) to prevent postnatal depression. […] The intervention was designed by modifying a previously evaluated one and includes information on normal pregnancy and the postpartum period, from psychoanalytic and risk factors perspectives. It attempts to reduce depression levels by increasing positive thinking and pleasant activities, improving self-esteem, increasing self-care, learning skills to strengthen social support, and exploring unrealistic expectations about pregnancy and motherhood.

• #18 NIH grant to examine universal postpartum depression prevention for moms | MSUToday | Michigan State UniversityMichigan State UniversityMichigan State UniversityMSUTODAYMSUTODAY

  https://msutoday.msu.edu/news/2022/nih-grant-for-postpartum-prevention

  Maternal mental health is a critical public health component of perinatal care and maternal safety. Postpartum depression can have lasting consequences for the mother, child, and family. After each birth, 1 in 7 women will experience postpartum depression. […] The Reach Out, Stand Strong, Essentials for New Mothers program, funded by NIH through the end of 2022, has served low-income women at 98 prenatal clinics. Study findings show that ROSE prevents half of the cases of postpartum depression. Additionally, health care and community agencies find it is more feasible to provide ROSE as universal prevention for all women. […] The U.S. Preventative Services Task Force recommends that women at risk for postpartum depression receive these preventive interventions. However, our experience implementing ROSE across the country suggests that a universal intervention may be better; easier for agencies, less stigmatizing for mothers, and no one is missed.

• #19 NIH grant to examine universal postpartum depression prevention for moms | MSUToday | Michigan State UniversityMichigan State UniversityMichigan State UniversityMSUTODAYMSUTODAY

  https://msutoday.msu.edu/news/2022/nih-grant-for-postpartum-prevention

  Utilizing a universal prevention model will help to reduce that stigma, remove barriers to help, and make maternal mental health support available to every mom. […] The ROSE scale-up project will assess the effectiveness, cost-outcome, equity, and scalability of a universal (i.e., available to everyone) vs. selective (i.e., available to only moms determined to be at risk) postpartum depression prevention model using commonly available and existing screening tools. […] ROSE has been recommended by the U.S. Preventative Services Task Force for women at risk for postpartum depression. The intervention is freely available to agencies and providers. The curriculum is highly structured, easy to learn, and available in Spanish and English. It does not require a mental health professional. ROSE can be offered in various settings, including prenatal clinics, doula organizations, home visiting programs, and WIC agencies.

• #20 Essential Reads: Strategies for the Prevention of Postpartum Depression – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/prevention-of-postpartum-depression-2/

  A peer support intervention is defined as “the provision of emotional assistance (e.g., attentive listening), appraisal assistance (communication of information that is pertinent to self-evaluation), and informational assistance (provision of knowledge relevant to problem-solving) by a created social network member who possesses experiential knowledge of a specific behavior or stressor and similar characteristics as the target population”. […] Most interventions thus far studied offer non-pharmacologic treatments; however, pharmacologic treatment may decrease risk for postpartum illness in women with a history of depression. […] It is clear that there are a number of interventions which can be used to reduce risk for postpartum depression in certain populations; however, we cannot use a one-size-fits-all kind of approach when making decisions regarding the care of women at increased risk for perinatal depression. […] Access to these programs is also a problem.

• #21 Journal of Medical Internet Research – Evaluation of a Technology-Based Peer-Support Intervention Program for Preventing Postnatal Depression (Part 1): Randomized Controlled Trial

  https://www.jmir.org/2019/8/e12410/

  Background: The frenzy of postbirth events often takes a toll on mothers mental well-being, leaving them susceptible to postpartum psychological disorders such as postnatal depression (PND). Social support has been found to be effective in restoring the emotional well-being of new mothers. Therefore, mothers need to be supported during the crucial postpartum period to buffer the negative after effects of childbirth and to promote healthier maternal well-being. […] The technology-based PIP was found to be effective in reducing the risk of PND among new mothers and showed a generally positive trend in reducing PNA and loneliness and increasing perceived social support. This study highlights the importance of training paraprofessionals to provide needed support for new mothers postpartum. […] This study aims to examine the effectiveness of a technology-based peer-support intervention program (PIP) among mothers at risk of PND during the early postpartum period (3 months postpartum). The secondary maternal outcomes examined were PNA, loneliness, and perceived social support.

• #22 Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial | The BMJ

  https://www.bmj.com/content/338/bmj.a3064

  Objective To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression. […] Conclusion Telephone based peer support can be effective in preventing postnatal depression among women at high risk. […] Telephone based peer support might be effective in preventing postnatal depression among women identified as high risk immediately postpartum. […] This finding is clinically important as most women who develop postnatal depression do so in the first 12 weeks after childbirth. […] Importantly, over 80% of women were satisfied with their peer support experience and would recommend it to a friend.

• #23 Identification and Management of Peripartum Depression | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0515/p852.html/1000

  Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. […] For first-time mothers, adolescent mothers, and mothers who have experienced a traumatic delivery, home health visits, telephone-based peer support, and psychotherapy may help prevent peripartum depression. […] Studies support the use of certain preventive measures, particularly in first-time mothers, adolescent mothers, and mothers who have experienced a traumatic delivery. Interventions with good-quality evidence are home health visits, telephone-based peer support, and psychotherapy (cognitive behavior and interpersonal therapies). […] A 2005 Cochrane review concluded that although the use of selective serotonin reuptake inhibitors (SSRIs) shows a modest benefit in the prevention of peripartum depression for mothers with previously diagnosed peripartum depression, there are insufficient data to recommend this use.

• #24 Postpartum Major Depression | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1015/p926.html

  Postpartum major depression is a disorder that is often unrecognized and must be distinguished from baby blues. […] Screening for antepartum or postpartum depression should be strongly considered, although evidence is lacking to support a recommendation for universal screening. […] Prophylactic treatment may involve psychotherapy beginning in the third trimester or medication offered immediately postpartum. […] Sertraline (Zoloft) has been shown to decrease the recurrence of postpartum major depression when started immediately after delivery. […] A thorough risk-benefit discussion with each patient is essential before deciding on treatment for postpartum major depression.

• #25 Prevention and Recurrence – APNI – Association for Post-Natal Illness | Post Natal Depression

  https://apni.org/prevention-and-recurrence/

  Studies done to date indicate that after an episode of post-natal depression there is a 50% chance of a recurrence of the illness after a subsequent birth. […] However, there are currently three methods of prevention in use and some basic advice may be of help. […] There is evidence that extra psychological support during a subsequent pregnancy reduces the likelihood of an episode of post-natal depression. […] There are two drug treatments used for preventing further episodes of post-natal depression. […] One method involves having high doses of progesterone injected during and after labour. […] The other method involves the use of anti-depressants in late pregnancy, usually in the last three weeks. […] It is advisable to discuss your options with your GP and midwife. […] In planning terms when you have already experienced post-natal depression you are best advised to assume that you will become depressed after a subsequent birth and try to plan accordingly.

• #26 Antidepressant medication for preventing postnatal depression | Cochrane

  https://www.cochrane.org/CD004363/DEPRESSN_antidepressant-medication-preventing-postnatal-depression

  We examined the evidence to see whether antidepressants can prevent women from experiencing depression in the postnatal period, when compared with any other treatment, sham treatment (placebo), or standard clinical care. […] Pregnant women who are not depressed, but are at high risk of developing postnatal depression, may want to consider taking measures to try to prevent depression developing in the postnatal period. […] We examined whether taking antidepressants during pregnancy or after giving birth can prevent women from developing postnatal depression. […] It is worth noting that no new relevant trials have been completed in the 10 years since we last examined this evidence. […] Due to the limitations of the current evidence base, such as the low statistical power of the included studies, it is not possible to draw any clear conclusions about the effectiveness of antidepressants for the prevention of postnatal depression.

• #27 Antidepressant medication for preventing postnatal depression | Cochrane

  https://www.cochrane.org/CD004363/DEPRESSN_antidepressant-medication-preventing-postnatal-depression

  Future reviews in this area may benefit from broadening their focus to examine the effectiveness of antidepressants for the prevention of perinatal (i.e. antenatal or postnatal) depression, which could include studies comparing antidepressant discontinuation with continuation for the prevention of relapse of depression during pregnancy and the postnatal period.

• #28 FDA Approves First Oral Treatment for Postpartum Depression | FDA

  https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-postpartum-depression

  Today, the U.S. Food and Drug Administration approved Zurzuvae (zuranolone), the first oral medication indicated to treat postpartum depression (PPD) in adults. […] Having access to an oral medication will be a beneficial option for many of these women coping with extreme, and sometimes life-threatening, feelings. […] The efficacy of Zurzuvae for the treatment of PPD in adults was demonstrated in two randomized, double-blind, placebo-controlled, multicenter studies. […] Patients in the Zurzuvae groups showed significantly more improvement in their symptoms compared to those in the placebo groups. […] The daily recommended dose for Zurzuvae is 50mg. It should be taken once every day, for 14 days, in the evening with a fatty meal.

• #29 First postpartum depression pill approved by FDA: What to know | Brain | Your Pregnancy Matters | UT Southwestern Medical Center

  https://utswmed.org/medblog/postpartum-depression-pill/

  New treatment options for postpartum depression could be beneficial to you and your baby. […] This summer, the U.S. Food and Drug Administration (FDA) approved the first pill specifically designed to treat PPD, which affects 10% to 15% of new mothers. […] Zuranolone pills are taken once a day for 14 days with no hospital stay. Early information about the medication is exciting: It appears to work quickly. Studies have shown that zuranolone can start to ease PPD symptoms in just three days, with full effects after two weeks. […] But zuranolone may prove to be an important tool in helping new moms feel like themselves again potentially faster when the medication becomes more widely available this fall. […] If SSRIs have not completely addressed your PPD symptoms in the past, zuranolone could be a better option. […] Women who do not have a strong support system at home or who have already returned to work may need to consider cognitive behavioral therapy or another depression medication. […] We are hopeful that news of zuranolones FDA approval will encourage more women to get treatment for PPD.

• #30 Preventing postpartum depression: Review and recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4308451/

  Postpartum depression is significantly undertreated. Many women feel that depression at what ought to be a joyful time is shameful, and others are influenced by society’s general stigma concerning mental health care. In addition, those women who do seek treatment often hesitate to take psychotropic medications when breastfeeding, despite substantial evidence of their relative safety (Beck, 2001) (Goodman, 2009) (Cott and Wisner, 2003, Freeman, 2007). […] In summary, out of eight RCTs of biological interventions for the prevention of PPD, three found a positive effect (Harrison-Hohner et al., 2001, for calcium; Wisner et al., 2004, for sertraline; Mokhber et al., 2011, for selenium), four found no effect (Harris et al., 2002, for thyroxine; Llorente et al., 2003, for omega-3s; Doornbos et al., 2009, for omega-3s; Makrides et al., 2010, for DHA), and one found a negative effect (Lawrie et al., 1998, for progestogen). […] In summary, of the psychosocial interventions, which include both antenatal and postnatal support and education, only five of thirteen trials were able to demonstrate significant differences between the control and intervention groups.

• #31 Treating Postpartum Depression – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/treating-postpartum-depression.asp

  Proper nutrition and dietary supplementation will help to support mood and energy levels during the postpartum period. Provide ideas for healthy nutrition and consider keeping a list of quick, nutritious recipes on hand. […] Dietary supplementation with omega-3 fats prenatally may decrease the risk of developing postpartum depression, as well as reduce some depressive symptoms in the postpartum period. […] Studies suggest a link between low serum vitamin D levels and an increased risk of postpartum depression. Correction of vitamin D deficiency may play a significant role in the recovery from postpartum depression. […] Exercise and fresh air can be very therapeutic to mothers, who often find themselves spending a lot of time indoors, tending to their babys needs. Movement is one of the most important, low-cost, and effective treatments for depression. […] Social connection is necessary during the postpartum time. Encourage mothers to ask for help and connect with family, friends, and supportive people through recreation, classes, religious groups, etc.

• #32 Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287650

  Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. […] As a new prescription tool, exercise interventions are not only an important non-pharmacological method in treating postpartum depression, but also effective in preventing this disorder. […] Current evidence supports that PPD can be effectively prevented and treated through exercise due to the postpartum-specific health outcomes including less urinary stress incontinence, less lactation-induced bone loss, reducing postpartum weight retention, and less anxiety and depression. […] The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention.

• #33 Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287650

  The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). […] Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.

• #34 Can You Avoid Postpartum Depression? | Hackensack Meridian Health

  https://www.hackensackmeridianhealth.org/en/healthu/2022/04/18/can-you-avoid-postpartum-depression

  While unfortunately theres no surefire way to ensure you wont experience postpartum depression (PPD), there are steps you can take to make sure you are well supported. […] Educating yourself and family members about postpartum depression is so important – it wont prevent it, but the signs and symptoms will be easier to pick up on and identify if seen, shares Lauren. […] Not only is eating well and exercising good for your growing baby, its good for your mental health, adds Lauren. […] Nature and sunlight are naturally proven effective for depression. Take a walk or sit outside if the weather permits. That little bit of sunshine can boost your mood and even help you sleep better at night, adds Lauren.

• #35 Postpartum depression

  https://womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

  Your body and mind go through many changes during and after pregnancy. If you feel sad, anxious, or overwhelmed or feel like you dont love or care for your baby and these feelings last longer than 2 weeks during or after pregnancy, you may have postpartum depression. Treatment for depression, such as therapy or medicine, works and can help you and your baby be as healthy as possible in the future. […] The U.S. Preventive Services Task Force recommends that doctors look for and ask about symptoms of depression during and after pregnancy, regardless of a womans risk of depression. […] Working with a health care professional is a good way to create a plan that will work for you. Here are some ways to get helpthey can be used alone or together: Therapy: Counseling or therapy sessions with a mental health professional can help you understand and cope with your emotions and challenges. Support groups: Joining a support group of others experiencing PPD can provide comfort and understanding. Self-care: Taking care of yourself is important. Do your best to get enough rest, eat food with a lot of nutrients like fresh produce and whole grains, be physically active, and ask for help when needed. Social support: Reach out to family, friends, or other people you trust who can offer advice or support. Medication: In some cases, medicine may be prescribed to help manage symptoms. The most common type is antidepressants. Antidepressants can help relieve symptoms of depression and some can be taken while you’re breastfeeding. Antidepressants may take several weeks to start working. […] Having depression can affect your baby. Getting treatment is important for you and your baby. Getting help is a sign of strength.

• #36 Prevention and Recurrence – APNI – Association for Post-Natal Illness | Post Natal Depression

  https://apni.org/prevention-and-recurrence/

  It can be useful to try and build up a network of support that suits your needs. […] It may be useful to discuss with your GP starting anti-depressant therapy without delay if you experience depression symptoms after the birth. […] If you expect to become ill again you may feel more able to seek treatment quickly should you notice any symptoms of depression after the birth.

• #37 Preventing postnatal depression | Centre for Adolescent Health

  https://blogs.rch.org.au/cah/2021/05/04/preventing-postnatal-depression/

  Preventing postnatal depression (PND) affects many women around the world and can limit womens own ongoing wellbeing, as well as their capacity to enjoy being a parent and engaging with their infants. […] New research, led by Dr Elizabeth Spry (Deputy Director of VIHCS at the Murdoch Childrens Research Institute, Centre for Adolescent Health) explored potential ways to prevent PND for at risk women. […] Findings suggest that we could potentially halve the risk of PND for at risk mothers by effective intervention during pregnancy, to reduce their depressive symptoms and improve their social support and quality relationships. […] Even greater opportunities to prevent PND may arise from a greater investment in preconception care, to disrupt the complex pathways increasing the risk of PND.

• #38 An Evaluation of the Health Economics of Postnatal Depression Prevention and Treatment Strategies in China: A Cost-Effectiveness Analysis

  https://www.mdpi.com/2227-9032/12/11/1076

  An Evaluation of the Health Economics of Postnatal Depression Prevention and Treatment Strategies in China: A Cost-Effectiveness Analysis […] Objective: The primary objectives of this study are to assess the cost-effectiveness of early postnatal screening and prenatal psychological interventions for the prevention and treatment of postpartum depression (PPD) among Chinese pregnant women. Additionally, we aim to explore the most cost-effective prevention and treatment strategies for PPD in China. […] Conclusion: Both early postnatal screening and prenatal psychological interventions are found to be highly cost-effective strategies for preventing and treating PPD in China. Prenatal psychological interventions for pregnant women are the most cost-effective prevention and treatment strategy. As such, from the perspective of national payers, we recommend that maternal screening for PPD be implemented in China to identify high-risk groups early on and to facilitate effective intervention. […] In China, both early postpartum screening and prenatal psychological interventions are cost-effective strategies for preventing and treating postpartum depression. Prenatal psychological interventions for women with postpartum depression are the most cost-effective prevention and treatment strategy. Therefore, from the perspective of national payers, we recommend implementing maternal–infant screening for postpartum depression in China to identify high-risk groups early and intervene effectively. By increasing investment and expenditure in the mental health of pregnant and postpartum women, the state can not only provide better medical protection for patients but also create a better working environment for medical workers, achieving a win–win situation for both parties.

• #39 The Ratu’s Model: A prevention model of postpartum depression | Enfermería Clínica

  https://www.elsevier.es/es-revista-enfermeria-clinica-35-articulo-the-ratu39s-model-a-prevention-S1130862119300233

  The Ratu’s Model is a nursing model to prevent postpartum depression, is a product of Ratu’s dissertation. Depression is one of the common psychological problem experienced by postpartum women. The number is estimated to reach 20% in Indonesia, 15-20% in the Riau Province, and must to be pressed to 1%. […] This study aims to identify the effectiveness of Ratu’s Model to prevent postpartum depression. […] A significant correlation between Ratu’s Model with lowered postpartum depression incidence. […] The Ratu’s Model is effective lowering the incidence of postpartum depression. […] The psychoeducation and the counseling during the period of pregnancy may reduce the incidence of depression during and after the pregnancy. […] The lowered incidence of the postpartum depression in the intervention group may also be caused by the nutrition consumed by the pregnant women, especially the nutrients that may even prevent postpartum depression. […] The Ratu’s Model is effective to lowering the incidence of postpartum depression. Its is recommended that the Ratu’s Model may be utilized as more focus in maternity nursing service to prevent of postpartum depression in any healthcare services.

• #40 ‘Next Stop: Mum’: Evaluation of a Postpartum Depression Prevention Strategy in Poland

  https://www.mdpi.com/1660-4601/19/18/11731

  ‘Next Stop: Mum’: Evaluation of a Postpartum Depression Prevention Strategy in Poland […] In the article we present a mid-point evaluation of the postpartum depression (PPD) prevention strategy in Poland. As PPD is associated with potential negative consequences for the mother and infant, the need to introduce screening and treatment is vital. […] Maintaining the assumptions of the program: training for medical staff, screening conducted throughout the first twelve months postpartum, online platform with the possibility of self-screening and early psychological intervention seem to be justified actions, leading to a higher number of women with risk of PPD referred. […] The program’s main objective is to increase the early detection of postpartum depression symptoms through education and public awareness of PPD. […] The ‘Next Stop: Mum’ PPD preventive program, covering the northern region of Poland, is a part of the project: ‘Development of the concept and substantive assumptions of health policy programs to be implemented under the competition procedure’ no. POWR.05.01.00-IP.05-00-006/18 and co-financed by the EU Society Funds under Operational Program: Knowledge Education Development.

• #41 Prevention of Postpartum Depression by Multidisciplinary Collaboration in Japan | JMA Journal

  https://www.jmaj.jp/detail.php?id=10.31662%2Fjmaj.2024-0070

  This is an outline of the prevention of postpartum depression in obstetric institutes, with a focus on support through multidisciplinary collaboration in Japan. The onset of postpartum depression among women can be prevented by finding solutions to background factors causing mental health problems and providing multidisciplinary support. […] In Japan, postpartum depression occurs in 10%-15% of postpartum women. One of the main causes of postpartum depression in this country has been reported to involve social factors, such as an unwanted and/or unexpected pregnancy, lack of support, and unstable family situation. […] Based on these background factors, we reviewed the prevention of perinatal mental disorders such as postpartum depression in obstetric institutes, with a focus on support through multidisciplinary cooperation.

• #42 Prevention of Postpartum Depression by Multidisciplinary Collaboration in Japan | JMA Journal

  https://www.jmaj.jp/detail.php?id=10.31662%2Fjmaj.2024-0070

  Thus, obstetricians and nursing professionals need to acquire communication skills in preparation for providing support; in recent years, several related organizations, including the Japan Obstetricians and Gynecologists Association, have been holding regular training sessions on how to communicate with pregnant and postpartum women using questionnaires. […] This suggests that preventing the onset of postpartum depression among women is possible by finding solutions to background factors causing their mental health problems and providing multidisciplinary support. […] Therefore, it is preferable for them to give birth as close to their residence as possible rather than being referred to a distant tertiary hospital. […] If the mental state of pregnant and postpartum women remains healthy, the homecoming delivery is a good opportunity to learn child-rearing in Japan, where the nuclear family has become increasingly common. […] Experience, skill, and wisdom about care of the baby can be passed on from the grandmother to the new mother. […] In conclusion, we have outlined the prevention of postpartum depression in obstetric institutes, with a focus on support through multidisciplinary cooperation.

• #43 Recommendations for the prevention and treatment of postpartum depression | Dominiak | Ginekologia Polska

  https://journals.viamedica.pl/ginekologia_polska/article/view/69183

  Recommendations for the prevention and treatment of postpartum depression were commissioned by the Polish Ministry of Health as a part of the Depression Prevention Program for 2016-2020. […] These recommendations focus on the management of suspected postpartum depression and provide specific guidelines for medical staff having contact with pregnant and postpartum women (gynecologists, midwives, pediatricians). […] Psychosocial and psychological interventions for preventing postpartum depression.

• #44 Antidepressant Prevention of Postnatal Depression | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030389

  The group of women at highest risk of PND because of a recent history of a major depressive episode may take antidepressants at conception as part of relapse prevention. […] Continuation of antidepressants through pregnancy in such women may prevent postnatal depression, but this was not tested in these studies. […] The evidence therefore does not allow us to make any recommendations about the role of antidepressants in preventing postpartum depression. […] Future research should refine the identification of high-risk women, compare the effectiveness of antidepressants and psychosocial treatments for women with depression in the postnatal period, and carry out long-term follow-up of women and their children, including monitoring of adverse effects for the mother and infant. […] Guidelines based on a review of the available evidence have concluded that in high-risk women it may be effective to provide postnatal visits, interpersonal therapy, and/or educational programmes on preparation for parenthood. […] The current evidence base therefore supports offering women at risk of PND intensive professionally based postpartum support for prevention of PND.

• #45 Psychological intervention for universal prevention of antenatal and postnatal depression among pregnant women: protocol for a systematic review and meta-analysis | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-1238-7

  Therefore, psychological interventions are needed that specifically target the perinatal condition and additional systematic reviews and meta-analyses of psychological interventions for universal prevention among pregnant women are required. […] Accordingly, the objective of this study is to evaluate the effects of psychological interventions on antenatal and postnatal depression during pregnancy by performing a systematic review and meta-analysis based on the latest articles and a broader literature search. […] Our study will systematically review and analyze the evidence for the effect of psychological interventions as a universal approach to the prevention of antenatal and postnatal depression among pregnant women. […] Furthermore, this study will promote future studies and clarify the direction of research on universal prevention of perinatal depression.

• #46 Postpartum depression: Prevention and multimodal therapy

  https://scholar.valpo.edu/jmms/vol5/iss2/4/

  A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. […] While some mothers have positive emotions at birth, such as joy and pleasure, others complain of negative experiences varying from sadness and depression to psychosis. […] Thus, the risk of depression is higher for women during the postpartum period, having a tendency to decrease in most cases over the first 2 weeks after delivery. […] Unfortunately, this favorable evolution does not happen in about 1 in 4-7 women, who develops postpartum depression. […] Taking into account all changes that occur during the peripartum period, a multimodal approach for postpartum depression would be recommended, including an appropriate lifestyle (walks, ambient environments), counseling, cognitive-behavioral therapy, and finally antidepressant medication when required. […] Antepartum and postpartum screening, an early diagnosis, and a tailored approach to depression are essential for better results and prognosis related to both mother and child.

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