USPSTF Recommends Counseling to Prevent Perinatal Depression

TUESDAY, Feb. 12, 2019 — The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians provide or refer counseling interventions for pregnant or postpartum women at increased risk for perinatal depression. This recommendation forms the basis of a final recommendation statement published in the Feb. 12 issue of the Journal of the American Medical Association.

Elizabeth O’Connor, Ph.D., from Kaiser Permanente in Portland, Oregon, and colleagues conducted a systematic review of the benefits and harms of primary care-relevant interventions to prevent perinatal depression. Data were included for 50 studies with 22,385 participants.

The researchers found that counseling interventions correlated with a lower likelihood of onset of perinatal depression compared with controls (pooled risk ratio, 0.61). The absolute difference in the risk for perinatal depression varied from a 1.3 to 31.8 percent greater reduction in the control and intervention groups, respectively. None of the behavior-based interventions reported on harms directly. Based on these findings, the USPSTF concluded that counseling interventions are effective and women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors would benefit from counseling interventions. Providing or referring pregnant or postpartum women at increased risk to counseling interventions would be of moderate net benefit.

“If the health care delivery system can make the necessary investment to implement these recommendations, they may return great dividends in the form of enhanced well-being of mothers and their offspring,” Marlene P. Freeman, M.D., from Massachusetts General Hospital in Boston, writes in an accompanying editorial.

Recommendation Statement
Evidence Review
Editorial 1
Editorial 2
Editorial 3 (subscription or payment may be required)
Editorial 4 (subscription or payment may be required)

Posted: February 2019

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