Draft Research Plan
Perinatal Depression: Preventive Interventions
February 23, 2023
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
- Do interventions to prevent perinatal depression improve health outcomes in pregnant or postpartum individuals or their children?
- In trials that limit enrollment to individuals at increased risk, how are participants identified as being at increased risk of developing perinatal depression?
- What harms are associated with interventions to prevent perinatal depression in pregnant or postpartum individuals?
Contextual questions will not be systematically reviewed and are not shown in the Analytic Framework.
- Are there reliable and valid prognostic tools for identifying individuals who are at increased risk of developing perinatal depression?
- When is the most effective time to provide interventions to prevent perinatal depression?
To the extent possible, we plan to describe the population, risk assessment, and intervention characteristics of the included studies. Data on population characteristics will help us to explore the degree to which the findings are representative of different populations of persons at risk for perinatal depression. These groups include, but are not limited to, categorizations by various social determinants of health, such as education, socioeconomic status, age, gender, and racial, ethnic, and cultural identity. We will endeavor to determine if depression prevention interventions developed and customized for specific populations are effective in those populations.
The proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions.
|Aim/ Objective||Studies with a primary aim to prevent perinatal depression||Studies restricted to screening for and treatment of depression during pregnancy or in the postpartum period|
|Population||Pregnant and postpartum (≤1 year) individuals; study may target individuals with mental health symptoms or disorders (see exceptions under exclusion criteria)||
|Interventions||Interventions to reduce the risk of perinatal depression initiated during pregnancy or the first year postpartum, including:
Maternal health outcomes:
|KQ 1: Maternal behavioral outcomes (e.g., increase in physical activity)|
|Timing of Outcome Assessment||KQ 1: ≥6 weeks after baseline assessment or intervention initiation
KQ 2: Any time after the intervention is initiated
|KQ 1: <6 weeks after baseline assessment or intervention initiation|
|Study Designs||KQ 1: RCTs
KQ 2: RCTs
|All other study designs (e.g., case report or case series)|
|Countries||Countries categorized as “Very High” on the 2021 Human Development Index, as defined by the United Nations Development Programme||Countries not categorized as “Very High” on the Human Development Index|
|Languages||English||Languages other than English|
|Quality||Fair or good, according to design-specific criteria||Poor, according to design-specific criteria|
Abbreviations: AIDS=acquired immunodeficiency syndrome; HIV=human immunodeficiency virus; KQ=key question; RCT=randomized, controlled trial.