Preventing postpartum depression part I: a review of biological interventions.
OBJECTIVE
This paper critically reviews the literature to determine the current state of scientific knowledge concerning the prevention of postpartum depression (PPD) from a biological perspective.


METHODS
The criteria used to evaluate the interventions were derived from the standardized methodology developed by the Canadian Task Force on Preventive Health Care. Databases searched for this review include Medline, PubMed, Cinahl, PsycINFO, Embase, ProQuest, the Cochrane Library, and the World Health Organization Reproductive Health Library. Studies selected were peer-reviewed English-language articles published between January 1, 1966, and December 31, 2003.


RESULTS
Seven studies that met criteria were examined. These studies focused on evaluating the preventive effect of antidepressant medication, estrogen and progesterone therapy, thyroid therapy, docosahexanoic acid, and calcium supplementation. Although some of these interventions have been examined rigorously for depression unrelated to childbirth, methodological study limitations render intervention efficacy equivocal for PPD; thus, there is limited strong evidence to guide practice or policy recommendations.


CONCLUSIONS
Despite the recent upsurge of interest in this area, many questions remain unanswered, which has several implications for research.
Dennis
Cindy-Lee E
CL
Faculty of Nursing, University of Toronto, Ontario. cindylee.dennis@utoronto.ca
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D019052:Depression, Postpartum / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004281:Docosahexaenoic Acids / Q000627:therapeutic use; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011374:Progesterone / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D004967:Estrogens; D004281:Docosahexaenoic Acids; D011374:Progesterone; D002118:Calcium