Effect of family-centered interventions for perinatal depression: an overview of systematic reviews

OBJECTIVE: This study aimed to evaluate and conclude the quality of critically systematic reviews (SRs) of the efficacy of family-centered interventions on perinatal depression.

METHODS: SRs of the efficacy of family-centered interventions on perinatal depression were systematically searched in nine databases. The retrieval period was from the inception of the database to December 31, 2022. In addition, two reviewers conducted an independent evaluation of the quality of reporting, bias risk, methodologies, and evidence using ROBIS (an instrument for evaluating the bias risk of SRs), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), AMSTAR 2 (an assessment tool for SRs), and grading of recommendations, assessment, development and evaluations (GRADE).

RESULTS: A total of eight papers satisfied the inclusion criteria. In particular, AMSTAR 2 rated five SRs as extremely low quality and three SRs as low quality. ROBIS graded four out of eight SRs as "low risk." Regarding PRISMA, four of the eight SRs were rated over 50%. Based on the GRADE tool, two out of six SRs rated maternal depressive symptoms as "moderate;" one out of five SRs rated paternal depressive symptoms as "moderate;" one out of six SRs estimated family functioning as "moderate," and the other evidence was rated as "very low" or "low." Of the eight SRs, six (75%) reported that maternal depressive symptoms were significantly reduced, and two SRs (25%) were not reported.

CONCLUSION: Family-centered interventions may improve maternal depressive symptoms and family function, but not paternal depressive symptoms. However, the quality of methodologies, evidence, reporting, and bias of risk in the included SRs of family-centered interventions for perinatal depression was not satisfactory. The above-mentioned demerits may negatively affect SRs and then cause inconsistent outcomes. Therefore, SRs with a low risk of bias, high-quality evidence, standard reporting, and strict methodology are necessary to provide evidence of the efficacy of family-centered interventions for perinatal depression.