NICU-based Interventions To Reduce Maternal Depressive and Anxiety Symptoms: A Meta-analysis.

Autor:	Mendelson T; Departments of Mental Health, and tmendel1@jhu.edu., Cluxton-Keller F; Dartmouth Geisel School of Medicine, Hanover, New Hampshire., Vullo GC; Total Child Health, Inc, Baltimore, Maryland; and., Tandon SD; Northwestern University Feinberg School of Medicine, Chicago, Illinois., Noazin S; International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2017 Mar; Vol. 139 (3). Date of Electronic Publication: 2017 Feb 21.
DOI:	10.1542/peds.2016-1870
Abstrakt:	Context: Parents whose infants are being treated in the NICU are at high risk for depression and anxiety, with negative implications for parenting and infant development. Objective: We conducted a systematic review and meta-analysis of NICU-based interventions to reduce maternal depressive or anxiety symptoms. Data Sources: PubMed, Embase, PsychInfo, Cochrane, and CINAHL were searched for relevant studies. Reference lists from selected studies were reviewed. Study Selection: Inclusion criteria included randomized controlled design, a parent-focused intervention delivered in the NICU, valid maternal depressive or anxiety symptom measures at pre- and postintervention, and publication in a peer-reviewed journal in English. Data Extraction: Data extraction was conducted independently by 2 coders. Results: Twelve studies met inclusion criteria for qualitative review; 2 were excluded from quantitative analyses for high risk of bias. Fixed- and random-effects models, with 7 eligible studies assessing depressive symptoms, indicated an effect of -0.16 (95% confidence interval [CI], -0.32 to -0.002; P < .05) and, with 8 studies assessing anxiety symptoms, indicated an effect of -0.12 (95% CI, -0.29 to 0.05; P = .17). The subset of interventions using cognitive behavioral therapy significantly reduced depressive symptoms (effect, -0.44; 95% CI, -0.77 to -0.11; P = .01). Limitations: The small number and methodological shortcomings of studies limit conclusions regarding intervention effects. Conclusions: Combined intervention effects significantly reduced maternal depressive but not anxiety symptoms. The evidence is strongest for the impact of cognitive behavioral therapy interventions on maternal depressive symptoms. (Copyright © 2017 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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