Psycho-educational interventions focused on maternal or infant sleep for pregnant women to prevent the onset of antenatal and postnatal depression: A systematic review

Natsu Sasaki; Naonori Yasuma; Erika Obikane; Zui Narita; Junpei Sekiya; Takuma Inagawa; Aiichiro Nakajima; Yuji Yamada; Ryuichi Yamazaki; Asami Matsunaga; Tomomi Saito; Kotaro Imamura; Kazuhiro Watanabe; Norito Kawakami; Daisuke Nishi

doi:10.1002/npr2.12155

Psycho-educational interventions focused on maternal or infant sleep for pregnant women to prevent the onset of antenatal and postnatal depression: A systematic review

Neuropsychopharmacol Rep. 2021 Mar;41(1):2-13. doi: 10.1002/npr2.12155. Epub 2020 Dec 19.

Authors

Affiliations

¹ Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
² Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
³ Takadanobaba Kokoro no Clinic, Tokyo, Japan.
⁴ Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
⁵ Department of Psychiatry, Jikei University school of medicine, Tokyo, Japan.
⁶ Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
⁷ Department of Obstetrics and Gynecology, School of Medicine, Juntendo University, Tokyo, Japan.
⁸ Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Abstract

Aims: This systematic review aimed to evaluate randomized controlled trials (RCTs) to examine the effect of maternal and infant sleep intervention during women's pregnancy for the purpose of preventing perinatal depression.

Method: A systematic search (from inception to January 28, 2019) for RCTs using five electronic databases-the Cochrane Controlled Register of Trials (CENTRAL), Embase, PubMed, PsycINFO, and Ichushi Web (Japan Medical Abstracts Society)-was conducted. Twelve investigators independently conducted initial screenings based on title and abstract, and then, two researchers performed full-text reviews one by one. A meta-analysis would be conducted if at least three studies were found. However, only two articles that met inclusion criteria, and narrative data synthesis was conducted for these two articles. The study protocol has been registered at PROSPERO (CRD42019119999).

Result: A total of 13 654 studies were initially searched. After removing duplicates, 10 547 studies were screened, and finally, two studies met the inclusion criteria. In both studies, the intervention was a one-time face-to-face session during pregnancy to deliver the behavioral knowledge and skills for optimizing sleep hygiene for both infant and mother. Effectiveness of the intervention in improving maternal mood was not significant in one study. In the other, there was a significant difference in maternal mood between the intervention and control group. No mood comparison was made between baseline and postintervention.

Conclusion: This study found limited evidence to support the effectiveness of sleep intervention for all pregnant women, which means "universal intervention," to protect maternal mental health. Further well-designed RCTs are needed to confirm these findings.

Keywords: CBT-I; antenatal depression; maternal and child health (MCH); postnatal depression; sleep disturbance; sleep hygiene; universal prevention.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Depressive Disorder / prevention & control*
Female
Humans
Patient Education as Topic / statistics & numerical data*
Pregnancy
Pregnancy Complications / prevention & control*
Psychotherapy, Brief / statistics & numerical data*
Sleep Wake Disorders / prevention & control*