Digital Health Interventions Show Promise in Alleviating Postpartum Depression and Anxiety

Digital health interventions modestly but notably reduce postpartum depression and anxiety symptoms compared to ‘treatment as usual,’ a systematic review of 31 randomized-controlled trials involving 10,024 participants found. 

Researchers from the Warren Alpert Medical School at Brown University, Providence, Rhode Island, and Washington University School of Medicine in St. Louis, Missouri, published the study in the American Journal of Obstetrics and Gynecology.

Study authors analyzed full-text data obtained from Ovid MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. The primary outcome was the score of postpartum depression or anxiety symptoms right after the intervention, while secondary outcomes included (1) positive screening for postpartum depression or anxiety and (2) ‘loss to follow-up,’ determined by comparing the number of participants who followed through to the final study assessment.

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Compared with treatment as usual, digital health interventions demonstrated a substantial reduction in mean scores for postpartum depression symptoms (29 studies: standardized mean difference, -0.64 [95% confidence interval, -0.88 to -0.40]; I2=94.4%) and postpartum anxiety symptoms (17 studies: standardized mean difference, -0.49 [95% confidence interval, -0.72 to -0.25]; I2=84.6%).

“In the few studies that assessed screen-positive rates for postpartum depression (n=4) or postpartum anxiety (n=1), there were no significant differences between those randomized to digital health intervention and treatment as usual,” authors wrote.

Additionally, there was a 38% increased risk of participants not completing the final assessment when exposed to digital health interventions compared to the treatment as usual group. However, participants randomized to app-based digital health interventions showed similar loss-to-follow-up rates as those subjected to traditional treatment methods (relative risk, 1.04 [95% confidence interval, 0.91-1.19]).

“More research is needed to identify digital health interventions that effectively prevent or treat postpartum depression and postpartum anxiety but encourage ongoing engagement throughout the study period,” authors concluded.

Reference

Lewkowitz AK, Whelan AR, Ayala NK, et al. The effect of digital health interventions on postpartum depression or anxiety: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2024;230(1):12-43. doi:10.1016/j.ajog.2023.06.028