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Pediatrics. 2017 Mar;139(3). pii: e20161870. doi: 10.1542/peds.2016-1870. Epub 2017 Feb 21.

NICU-based Interventions To Reduce Maternal Depressive and Anxiety Symptoms: A Meta-analysis.

Author information

1
Departments of Mental Health, and tmendel1@jhu.edu.
2
Dartmouth Geisel School of Medicine, Hanover, New Hampshire.
3
Total Child Health, Inc, Baltimore, Maryland; and.
4
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
5
International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Abstract

CONTEXT:

Parents whose infants are being treated in the NICU are at high risk for depression and anxiety, with negative implications for parenting and infant development.

OBJECTIVE:

We conducted a systematic review and meta-analysis of NICU-based interventions to reduce maternal depressive or anxiety symptoms.

DATA SOURCES:

PubMed, Embase, PsychInfo, Cochrane, and CINAHL were searched for relevant studies. Reference lists from selected studies were reviewed.

STUDY SELECTION:

Inclusion criteria included randomized controlled design, a parent-focused intervention delivered in the NICU, valid maternal depressive or anxiety symptom measures at pre- and postintervention, and publication in a peer-reviewed journal in English.

DATA EXTRACTION:

Data extraction was conducted independently by 2 coders.

RESULTS:

Twelve studies met inclusion criteria for qualitative review; 2 were excluded from quantitative analyses for high risk of bias. Fixed- and random-effects models, with 7 eligible studies assessing depressive symptoms, indicated an effect of -0.16 (95% confidence interval [CI], -0.32 to -0.002; P < .05) and, with 8 studies assessing anxiety symptoms, indicated an effect of -0.12 (95% CI, -0.29 to 0.05; P = .17). The subset of interventions using cognitive behavioral therapy significantly reduced depressive symptoms (effect, -0.44; 95% CI, -0.77 to -0.11; P = .01).

LIMITATIONS:

The small number and methodological shortcomings of studies limit conclusions regarding intervention effects.

CONCLUSIONS:

Combined intervention effects significantly reduced maternal depressive but not anxiety symptoms. The evidence is strongest for the impact of cognitive behavioral therapy interventions on maternal depressive symptoms.

PMID:
28223373
DOI:
10.1542/peds.2016-1870
[Indexed for MEDLINE]
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