The effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis.
Anxiety
CAM, complementary and alternative medicine
Complementary medicine and therapies
Depression
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
15 02 2019
15 02 2019
Historique:
received:
19
04
2018
revised:
16
09
2018
accepted:
03
11
2018
pubmed:
14
11
2018
medline:
10
4
2019
entrez:
14
11
2018
Statut:
ppublish
Résumé
Depression and anxiety are common during the antenatal and postnatal period, and are known to have a significant impact on the woman and her unborn infant. Pregnant women state a preference for non-pharmacological treatment options, and use complementary medicines and therapies to manage these symptoms. We examined the effectiveness and safety of these modalities on depression and anxiety during pregnancy. CENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials comparing complementary therapies and medicines to a control, for pregnant women with depression or anxiety. The primary outcome measure was antenatal depression or anxiety. Twenty randomised controlled trials containing 1092 women were included in the review. We found some evidence of reduced antenatal depression from three modalities. Acupuncture reduced the number of women diagnosed with antenatal depression (RR 1.68, 95% CI 1.06-2.66, 1 trial). Massage reduced the severity of antenatal depression in one trial of 149 women (SMD -0.73, 95%CI -1.07--0.39). One small trial of bright light therapy found reduced antenatal depression (RR 4.80, 95% CI -8.39--1.21, 27 women). There was no evidence of a reduction in depression and anxiety from relaxation, yoga, mindfulness and fish oils. Overall the risk of bias was high or unclear for the majority of studies. There are few high quality randomised controlled trials of complementary medicines and therapies examining the effect on anxiety and depression. Acupuncture, bright light therapy, and massage may reduce antenatal depression. There is a need for high quality and larger studies that include postnatal follow up and maternal and neonatal outcomes.
Sections du résumé
BACKGROUND
Depression and anxiety are common during the antenatal and postnatal period, and are known to have a significant impact on the woman and her unborn infant. Pregnant women state a preference for non-pharmacological treatment options, and use complementary medicines and therapies to manage these symptoms. We examined the effectiveness and safety of these modalities on depression and anxiety during pregnancy.
METHODS
CENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials comparing complementary therapies and medicines to a control, for pregnant women with depression or anxiety. The primary outcome measure was antenatal depression or anxiety.
RESULTS
Twenty randomised controlled trials containing 1092 women were included in the review. We found some evidence of reduced antenatal depression from three modalities. Acupuncture reduced the number of women diagnosed with antenatal depression (RR 1.68, 95% CI 1.06-2.66, 1 trial). Massage reduced the severity of antenatal depression in one trial of 149 women (SMD -0.73, 95%CI -1.07--0.39). One small trial of bright light therapy found reduced antenatal depression (RR 4.80, 95% CI -8.39--1.21, 27 women). There was no evidence of a reduction in depression and anxiety from relaxation, yoga, mindfulness and fish oils. Overall the risk of bias was high or unclear for the majority of studies.
LIMITATIONS
There are few high quality randomised controlled trials of complementary medicines and therapies examining the effect on anxiety and depression.
CONCLUSION
Acupuncture, bright light therapy, and massage may reduce antenatal depression. There is a need for high quality and larger studies that include postnatal follow up and maternal and neonatal outcomes.
Identifiants
pubmed: 30423471
pii: S0165-0327(18)30806-1
doi: 10.1016/j.jad.2018.11.054
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
428-439Informations de copyright
Copyright © 2018 Elsevier B.V. All rights reserved.