title: The effectiveness of antenatal interventions to prevent postnatal depression in high-risk women.
abstract: BACKGROUND
  Postnatal depression can have a major impact on the lives of women affected and on those around them. While effective treatments are available, it would be preferable to prevent the condition. The aim of this review was to examine the effectiveness of antenatal interventions designed to prevent postnatal depression in high-risk women.
  
  
  METHODS
  Randomised controlled trials of interventions to prevent postnatal depression delivered to high-risk women in pregnancy were identified through an electronic database search and a reference list search. Information regarding the selection criteria, content and delivery of the interventions was extracted and synthesised.
  
  
  RESULTS
  Eleven studies met the review inclusion criteria. Six described interventions that were significantly more effective in reducing the incidence and/or symptoms of postnatal depression than a control condition. Interventions were most likely to be effective when delivered to women who were depressed during pregnancy and when incorporating evidence-based psychological treatments for depression and addressing interpersonal difficulties.
  
  
  CONCLUSIONS
  It is possible that unpublished trials of antenatal interventions to prevent postnatal depression exist that were not detected. Due to the recognised publication bias, these studies may have been less likely to find a significant effect of antenatal interventions on postnatal depression.
  
  
  CONCLUSIONS
  There is evidence to suggest that interventions delivered in pregnancy can be effective in preventing postnatal depression. However, these interventions may be better conceptualised as treatment than prevention as they were delivered to women experiencing antenatal depression. There is a need to identify pregnant women experiencing depression and deliver evidence-based psychological interventions.
authors.affiliation: Department of Applied Psychology, Canterbury Christ Church University, Broomhill Road, Tunbridge Wells, Kent, UK. janeclatworthy@btinternet.com
authors.forename: Jane
authors.initials: J
authors.lastname: Clatworthy
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000517:prevention & control*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology* / Q000628:therapy*; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011295:Prenatal Care; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult