Review articleThe effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis
Section snippets
Background
Depression and anxiety in pregnancy frequently co-exist (Lee et al., 2007), and are common conditions experienced by pregnant women across countries. Up to 13% of women will experience major depression during pregnancy, with increasing prevalence up to around 22% in the first twelve months postpartum (Wisner et al., 2013). Postnatal depression (PND) is one of the most common forms of maternal morbidity following childbirth, and can lead to a chronic or recurring depression throughout the
Study selection and eligibility
A priori we included parallel randomised, cross over or quasi randomised controlled trials comparing complementary health approaches for women diagnosed or screening positive for clinical anxiety and depression during the antenatal period with placebo/no treatment, medication, or any psychological intervention. We included studies of women with antenatal anxiety and or depression (variously defined), and aged 16 years or above. The primary outcome was antenatal depression or anxiety. Secondary
Results
A total of 156 potential references were identified from database searches and other sources. After duplicates were removed, the studies were sequentially examined by title, abstract, and full text for eligibility (Fig. 1). Twenty trials containing 1092 women met the inclusion criteria for our review. Twenty studies were excluded. Thirteen studies were excluded due to women not meeting a clinical diagnosis of anxiety or depression (Field et al., 1999, Haakstad et al., 2016, Karol and von
Discussion
This review included 20 clinical trials containing 1092 women with anxiety or depression during pregnancy. Seven complementary health modalities were included, studies were conducted in five countries, and varied in their methodological quality. There was some evidence from four CM approaches of a potential benefit. Acupuncture reduced the number of women with depression during the antenatal period, but not in the postnatal period, and did not reduce the severity of symptoms. Although animal
Conclusion
There is preliminary very low to moderate quality evidence from complementary health approaches to reduce anxiety and depression. However few well designed RCTs have been conducted evaluating complementary health modalities on perinatal mental health during pregnancy and in the postnatal period. These interventions are accessible to women in the community and further studies are needed to assist women and their clinicians to make evidence-based, informed decisions about the management of
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author contributions
CS deigned the study.
ZS undertook the search of the literature.
CS and ZS screened all studies.
All authors contributed to data extraction, read and commented on the draft and approved the final version of the paper.
Declarations of interest
Caroline Smith and Zewdneh Shewamene declare as a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies and industry. Sponsors and donors provide untied and tied funding for work to advance
Acknowledgements
Nil.
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2022, Complementary Therapies in MedicineCitation Excerpt :There was insufficient evidence that acupressure improved anxiety outcomes for high-risk pregnant women. Acupressure involves applying pressure to specific acupressure points using fingers, hands, thumbs, elbows, or various other devices and has been considered a useful technique to maintain health and alleviate the symptoms of health problems in a variety of patient populations.23,50,51 However, only one study was included, and it used a self-report questionnaire to evaluate the subjective aspect of anxiety over a short period.