A Systematic Review of Psychosocial Interventions for Women with Postpartum Stress

Objective: To analyze the effects of psychosocial interventions with the aim of reducing the intensity of stress in mothers during the postpartum period as compared with usual care. Data Sources: Eligible studies were identified by searching MEDLINE, EMBASE, CINAHL, and ProQuest dissertations and theses. Study Selection: Randomized controlled trials (RCTs) treating stress in postpartum mothers older than age 19 years were included. The suitability of the quality of articles was evaluated using Joanna Briggs Institute's Critical Appraisal Checklist for Experimental Studies. Fourteen articles met the inclusion criteria for data analysis. Data Extraction: Authors, country, sample, setting, methods, time period, major content of the intervention, outcome measures, and salient findings were extracted and summarized in a data extraction form for further analysis and synthesis. Data Synthesis: Standardized mean differences with 95% confidence intervals were calculated for 13 suitable articles using Cochrane Review Manager. Results: Of 1,871 publications, 14 RCTs, conducted between 1994 and 2012, were evaluated in the systematic review and 13 studies were included in the meta-analysis. Studies were categorized into three major types by interventional methods. We found that psychosocial interventions in general (standardmean difference-1.66, 95% confidence interval [-2.74, -0.57], p =.003), and supportive stress management programs in particular (standard mean difference -0.59, 95% confidence interval [-0.94, -0.23], p =.001), were effective for women dealing with postpartum stress. Conclusions: This review indicated that psychosocial interventions including supportive stress management programs are effective for reducing postpartum stress in women, so those interventions should become an essential part of maternity care.