Effectiveness of interventions to prevent perinatal depression: An umbrella review of systematic reviews and meta-analysis

Emma Motrico, Rena Bina, Angelos P. Kassianos, Huynh Nhu Le, Vera Mateus, Deniz Oztekin, Maria F. Rodriguez- Muñoz, Patricia Moreno-Peral, Sonia Conejo-Cerón

Research output: Contribution to journalArticlepeer-review


Background: To date, dozens of systematic reviews (SRs) and meta-analyses (MAs) summarize the effectiveness of preventive interventions for perinatal depression. However, the results are inconclusive, making an urgent need to step up to higher levels of evidence synthesis. Aims: To summarize and compare the evidence from the SR&MA examining the effectiveness of all types of interventions for preventing perinatal depression. Method: PubMed, PsycINFO, Cochrane Database of Systematic Reviews and OpenGrey were searched from inception to December 2022. We selected SR&MA of randomized controlled trials (RCTs) that compared all types of preventive interventions for perinatal depression with control groups whose outcome was the reduction of depressive symptoms and/or incidence of new cases of perinatal depression (PROSPERO: CRD42020173125). Results: A total of 19 SRs and MAs evaluated 152 unique RCTs that included 83,408 women from 26 countries and five continents. The median effect size for any intervention was SMD = 0.29 (95% CI: 0.20 to 0.38). Exercise/physical activity-based, psychological, and any type of intervention showed median effect sizes of 0.43, 0.28 and 0.36, respectively. The degree of overlap among RCTs was slight. According to AMSTAR-2, 79% of them were rated as low or critically low-quality. The strength of evidence, according to GRADE, was poorly reported and, in most cases, was low. Conclusions: Exercise/physical activity-based and psychological interventions have a small-to-medium effect on reducing perinatal depressive symptoms. There is insufficient evidence to conclude that dietary supplements and pharmacological interventions are effective in preventing perinatal depression. There is a need for high-quality SR&MA of RCTs, mainly focusing on universal preventive interventions.

Original languageEnglish
Pages (from-to)47-61
Number of pages15
JournalGeneral Hospital Psychiatry
StatePublished - 1 May 2023


  • Perinatal
  • Prevention
  • Randomized control trial
  • depression
  • meta-analysis
  • systematic review

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health


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