Evidence in the diagnosis and treatment of postpartum depression: a narrative review

Abstract

Introduction: Postpartum depression is one of the most common medical complications associated with adverse short- and long-term perinatal outcome in the mother, infant, and family. Objective: To describe various diagnostic methods and therapies used for the management of postpartum depression and to analyze the recommendations generated by different scientific groups (maternal-fetal medicine, American College of Obstetrics and Gynecology, NICE guidelines, psychiatry, pediatrics). Methodology: Different search strategies were used in the databases Medline (via Pubmed), Scopus, Web of Science, Embase, Cochrane, OVID Psycho, from January 01, 2020 to February 01, 2023, using the keywords "postpartum depression", "antidepressants", "cognitive behavioral therapy", "interpersonal therapy", "mindfulness", controlled vocabulary. Two investigators independently reviewed study titles and abstracts. Results: About 14% of pregnant women develop postpartum depression. The most relevant risk factors are a history of anxiety, depression, history of psychiatric treatment, history of physical abuse, postpartum medical complications. Conclusions: One in seven patients (14%) develop perinatal depression. Tools such as the Edinburgh Scale should be applied to all pregnant women at their first prenatal check-up appointment, during the third trimester and in the postpartum period. There are several safe therapies that have demonstrated symptom reduction and decreased levels of relapse, with few side effects.