Mindfulness-Based Interventions for Postpartum Depression: A Systematic Review and Meta-Analysis
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Abstract
Background: We aimed to investigate the intervention effect of mindfulness-based interventions (MBIs) in patients with postpartum depression.
Methods: The method of computer and manual keyword retrieval was used to search PubMed, Web of Science, Cochrane Library. Literature included in the study was assessed for quality and meta-analysis was performed using RevMan 5.3 software.
Results: Twelve articles were finally included in the study and the meta-analysis showed that 6 articles used the Edinburgh Postnatal Depression Scale (EPDS) to compare MBIs with conventional therapy, and the statistical heterogeneity between the combined results was low (P=0.18, I2=32%). The level of depression in postpartum depression patients was lower in the MBIs group than in the conventional group [MD=3.13, 95%CI (2.57, 3.70), P<0.00001]. Based on the Beck Depression Inventory (BDI), the comparison between MBIs and conventional therapy had low statistical heterogeneity between the combined results (P=0.56, I2=0%). The level of depression in patients with postpartum depression who received MBIs was significantly lower than in the conventional care group [MD=5.89, 95%CI (4.88, 6.91), P<0.00001]. Subgroup analysis showed that the best intervention duration for MBIs for postpartum depression was within 4 weeks (SMD=-1.785), each session≦60 minutes (SMD=-1.435), and participants had to complete the best three times per week (SMD=-2.185).
Conclusion: MBIs can alleviate depression in women, thereby facilitating their adjustment to new life. It is recommended to practice mindfulness meditation for 30 minutes per day.Mindfulness
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2. Wan EY, Moyer CA, Harlow SD, et al (2009). Postpartum depression and traditional postpartum care in China: role of zuo-yuezi. Int J Gynaecol Obstet, 104(3): 209-213.
3. Leduc D, Senikas V, Lalonde A B, et al (2009). Active management of the third stage of labour: prevention and treat-ment of postpartum hemorrhage. J Ob-stet Gynaecol Can, 31(10): 980-993.
4. Zhao L, Chen J, Lan L, et al (2021). Effec-tiveness of Telehealth Interventions for Women with Postpartum Depression: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth, 9(10): e32544.
5. Eustis EH, Ernst S, Sutton K, Battle CL (2019). Innovations in the Treatment of Perinatal Depression: the Role of Yoga and Physical Activity Interventions dur-ing Pregnancy and Postpartum. Curr Psy-chiatry Rep, 21(12): 133.
6. Jakobsen J C, Gluud C, Kirsch I (2020). Should antidepressants be used for ma-jor depressive disorder?. BMJ Evidence-Based Medicine, 25(4): 130-130.
7. Majeed MH, Ali AA, Sudak DM (2018). Mindfulness-based interventions for chronic pain: Evidence and applications. Asian J Psychiatr, 32: 79-83.
8. Werneke U, Northey S, Bhugra D (2006). Antidepressants and sexual dysfunction. Acta Psychiatrica Scandinavica, 114(6): 384-397.
9. Shulman B, Dueck R, Ryan D, et al (2018). Feasibility of a mindfulness-based cog-nitive therapy group intervention as an adjunctive treatment for postpartum de-pression and anxiety. J Affect Disord, 235: 61-67.
10. Nyklíček I, Kuijpers K F (2008). Effects of mindfulness-based stress reduction in-tervention on psychological well-being and quality of life: is increased mind-fulness indeed the mechanism?. Ann Be-hav Med, 35(3): 331-340.
11. Shapiro S L, Carlson L E, Astin J A, et al (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3): 373-386.
12. Hofmann SG, Gómez AF (2017). Mindful-ness-Based Interventions for Anxiety and Depression. Psychiatr Clin North Am, 40(4): 739-749.
13. Tomfohr-Madsen LM, Campbell TS, Giesbrecht GF, Letourneau NL, Carlson LE, Madsen JW, Dimidjian S (2016). Mindfulness-based cognitive therapy for psychological distress in pregnancy: study protocol for a randomized con-trolled trial. Trials, 17(1): 498.
14. Duncan LG, Cohn MA, Chao MT, Cook JG, Riccobono J, Bardacke N (2017). Bene-fits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth, 17(1): 140.
15. Tabi K, Bhullar M, Fantu L, et al (2022). Feasibility of online mindfulness-based interventions for families affected with postpartum depression and anxiety: study protocol. BMJ Open, 12(9): e051935.
16. Dhillon A, Sparkes E, Duarte RV (2017). Mindfulness-based interventions during pregnancy: a systematic review and me-ta-analysis. Mindfulness (N Y), 8: 1421-1437.
17. Matvienko-Sikar K, Lee L, Murphy G, Mur-phy L (2016). The effects of mindfulness interventions on prenatal well-being: A systematic review. Psychol Health, 31(12): 1415-1434.
18. Baggett KM, Davis B, Sheeber LB, et al (2020). Minding the Gatekeepers: Refer-ral and Recruitment of Postpartum Mothers with Depression into a Ran-domized Controlled Trial of a Mobile Internet Parenting Intervention to Im-prove Mood and Optimize Infant Social Communication Outcomes. Int J Environ Res Public Health, 17(23): 8978.
19. Dimidjian S, Goodman SH, Felder JN, Gallop R, Brown AP, Beck A (2016). Staying well during pregnancy and the postpartum: a pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse /recurrence. J Consult Clin Psychol, 84 (2): 134-145.
20. Goetz M, Schiele C, Müller M, et al (2020). Effects of a Brief Electronic Mindful-ness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Wom-en: Exploratory Pilot Study. J Med Internet Res, 22(8): e17593.
21. Guo L, Zhang J, Mu L, Ye Z (2020). Prevent-ing Postpartum Depression with Mind-ful Self-Compassion Intervention: A Randomized Control Study. J Nerv Ment Dis, 208(2): 101-107.
22. Liu C, Chen H, Zhou F, et al (2022). Positive intervention effect of mobile health application based on mindfulness and social support theory on postpartum depression symptoms of puerperae. BMC Womens Health, 22(1): 413.
23. Miklowitz DJ, Semple RJ, Hauser M, Elkun D, Weintraub MJ, Dimidjian S (2015). Mindfulness-based cognitive therapy for perinatal women with depression or bi-polar spectrum disorder. Cognit Ther Res, 39: 590–600.
24. Zhang H, Emory EK (2015). A Mindfulness-Based Intervention for Pregnant Afri-can-American Women. Mindfulness, 6: 663-674.
25. Luberto CM, Park ER, Goodman JH (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9: 850-859.
26. Mei R, Peng F, Xiong J, et al (2022). Mind-fulness-Based Interventions for the Oc-currence of Postpartum Depression in Elderly 14. Primiparas. Contrast Media Mol Imaging, 2022: 4202676.
27. Pan WL, Chang CW, Chen SM, Gau ML (2019). Assessing the effectiveness of mindfulness-based programs on mental health during pregnancy and early motherhood—a randomized control trial. BMC Preg Childb, 19: 1-18.
28. Sheydaei H, Ghasemzadeh A, Lashkari A, Kajani PG (2017). The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electron Physician, 9(7): 4753-4758.
29. Sun Y, Li Y, Wang J, Chen Q, Bazzano AN, Cao F (2021). Effectiveness of Smartphone-Based Mindfulness Train-ing on Maternal Perinatal Depression: Randomized Controlled Trial. J Med In-ternet Res, 23(1): e23410.
30. Vieten C, Astin J (2008). Effects of a mind-fulness-based intervention during preg-nancy on prenatal stress and mood: re-sults of a pilot study. Arch Womens Ment Health, 11: 67-74.
31. Dunn C, Hanieh E, Roberts R, Powrie R (2012). Mindful pregnancy and child-birth: effects of a mindfulness-based in-tervention on women's psychological distress and well-being in the perinatal period. Arch Womens Ment Health, 15(2): 139-43.
32. Rayan A, Ahmad M (2017). Effectiveness of Mindfulness-Based Intervention on Per-ceived Stress, Anxiety, and Depression among Parents of Children with Autism Spectrum Disorder. Mindfulness, 8: 677–690.
2. Wan EY, Moyer CA, Harlow SD, et al (2009). Postpartum depression and traditional postpartum care in China: role of zuo-yuezi. Int J Gynaecol Obstet, 104(3): 209-213.
3. Leduc D, Senikas V, Lalonde A B, et al (2009). Active management of the third stage of labour: prevention and treat-ment of postpartum hemorrhage. J Ob-stet Gynaecol Can, 31(10): 980-993.
4. Zhao L, Chen J, Lan L, et al (2021). Effec-tiveness of Telehealth Interventions for Women with Postpartum Depression: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth, 9(10): e32544.
5. Eustis EH, Ernst S, Sutton K, Battle CL (2019). Innovations in the Treatment of Perinatal Depression: the Role of Yoga and Physical Activity Interventions dur-ing Pregnancy and Postpartum. Curr Psy-chiatry Rep, 21(12): 133.
6. Jakobsen J C, Gluud C, Kirsch I (2020). Should antidepressants be used for ma-jor depressive disorder?. BMJ Evidence-Based Medicine, 25(4): 130-130.
7. Majeed MH, Ali AA, Sudak DM (2018). Mindfulness-based interventions for chronic pain: Evidence and applications. Asian J Psychiatr, 32: 79-83.
8. Werneke U, Northey S, Bhugra D (2006). Antidepressants and sexual dysfunction. Acta Psychiatrica Scandinavica, 114(6): 384-397.
9. Shulman B, Dueck R, Ryan D, et al (2018). Feasibility of a mindfulness-based cog-nitive therapy group intervention as an adjunctive treatment for postpartum de-pression and anxiety. J Affect Disord, 235: 61-67.
10. Nyklíček I, Kuijpers K F (2008). Effects of mindfulness-based stress reduction in-tervention on psychological well-being and quality of life: is increased mind-fulness indeed the mechanism?. Ann Be-hav Med, 35(3): 331-340.
11. Shapiro S L, Carlson L E, Astin J A, et al (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3): 373-386.
12. Hofmann SG, Gómez AF (2017). Mindful-ness-Based Interventions for Anxiety and Depression. Psychiatr Clin North Am, 40(4): 739-749.
13. Tomfohr-Madsen LM, Campbell TS, Giesbrecht GF, Letourneau NL, Carlson LE, Madsen JW, Dimidjian S (2016). Mindfulness-based cognitive therapy for psychological distress in pregnancy: study protocol for a randomized con-trolled trial. Trials, 17(1): 498.
14. Duncan LG, Cohn MA, Chao MT, Cook JG, Riccobono J, Bardacke N (2017). Bene-fits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth, 17(1): 140.
15. Tabi K, Bhullar M, Fantu L, et al (2022). Feasibility of online mindfulness-based interventions for families affected with postpartum depression and anxiety: study protocol. BMJ Open, 12(9): e051935.
16. Dhillon A, Sparkes E, Duarte RV (2017). Mindfulness-based interventions during pregnancy: a systematic review and me-ta-analysis. Mindfulness (N Y), 8: 1421-1437.
17. Matvienko-Sikar K, Lee L, Murphy G, Mur-phy L (2016). The effects of mindfulness interventions on prenatal well-being: A systematic review. Psychol Health, 31(12): 1415-1434.
18. Baggett KM, Davis B, Sheeber LB, et al (2020). Minding the Gatekeepers: Refer-ral and Recruitment of Postpartum Mothers with Depression into a Ran-domized Controlled Trial of a Mobile Internet Parenting Intervention to Im-prove Mood and Optimize Infant Social Communication Outcomes. Int J Environ Res Public Health, 17(23): 8978.
19. Dimidjian S, Goodman SH, Felder JN, Gallop R, Brown AP, Beck A (2016). Staying well during pregnancy and the postpartum: a pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse /recurrence. J Consult Clin Psychol, 84 (2): 134-145.
20. Goetz M, Schiele C, Müller M, et al (2020). Effects of a Brief Electronic Mindful-ness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Wom-en: Exploratory Pilot Study. J Med Internet Res, 22(8): e17593.
21. Guo L, Zhang J, Mu L, Ye Z (2020). Prevent-ing Postpartum Depression with Mind-ful Self-Compassion Intervention: A Randomized Control Study. J Nerv Ment Dis, 208(2): 101-107.
22. Liu C, Chen H, Zhou F, et al (2022). Positive intervention effect of mobile health application based on mindfulness and social support theory on postpartum depression symptoms of puerperae. BMC Womens Health, 22(1): 413.
23. Miklowitz DJ, Semple RJ, Hauser M, Elkun D, Weintraub MJ, Dimidjian S (2015). Mindfulness-based cognitive therapy for perinatal women with depression or bi-polar spectrum disorder. Cognit Ther Res, 39: 590–600.
24. Zhang H, Emory EK (2015). A Mindfulness-Based Intervention for Pregnant Afri-can-American Women. Mindfulness, 6: 663-674.
25. Luberto CM, Park ER, Goodman JH (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9: 850-859.
26. Mei R, Peng F, Xiong J, et al (2022). Mind-fulness-Based Interventions for the Oc-currence of Postpartum Depression in Elderly 14. Primiparas. Contrast Media Mol Imaging, 2022: 4202676.
27. Pan WL, Chang CW, Chen SM, Gau ML (2019). Assessing the effectiveness of mindfulness-based programs on mental health during pregnancy and early motherhood—a randomized control trial. BMC Preg Childb, 19: 1-18.
28. Sheydaei H, Ghasemzadeh A, Lashkari A, Kajani PG (2017). The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electron Physician, 9(7): 4753-4758.
29. Sun Y, Li Y, Wang J, Chen Q, Bazzano AN, Cao F (2021). Effectiveness of Smartphone-Based Mindfulness Train-ing on Maternal Perinatal Depression: Randomized Controlled Trial. J Med In-ternet Res, 23(1): e23410.
30. Vieten C, Astin J (2008). Effects of a mind-fulness-based intervention during preg-nancy on prenatal stress and mood: re-sults of a pilot study. Arch Womens Ment Health, 11: 67-74.
31. Dunn C, Hanieh E, Roberts R, Powrie R (2012). Mindful pregnancy and child-birth: effects of a mindfulness-based in-tervention on women's psychological distress and well-being in the perinatal period. Arch Womens Ment Health, 15(2): 139-43.
32. Rayan A, Ahmad M (2017). Effectiveness of Mindfulness-Based Intervention on Per-ceived Stress, Anxiety, and Depression among Parents of Children with Autism Spectrum Disorder. Mindfulness, 8: 677–690.
| Files | ||
| Issue | Vol 52 No 12 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i12.14311 | |
| Keywords | ||
| Mindfulness Postpartum depression BDI Edinburgh postnatal depression scale (EPDS) | ||
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How to Cite
1.
Yang M, Song B, Jiang Y, Lin Y, Liu J. Mindfulness-Based Interventions for Postpartum Depression: A Systematic Review and Meta-Analysis. Iran J Public Health. 2023;52(12):2496-2505.
