Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79
To evaluate the maternal outcomes in women with postpartum depression using zuranolone, the first oral medication indicated to treat postpartum depression.
We conducted a systematic search in September 2023, on Pubmed, Embase and Cochrane Trials. We included randomized controlled trials comparing the effectiveness and safety of zuranolone versus placebo in women with postpartum depression. No time or language restrictions were applied. 297 results were retrieved, of which 11 papers were selected and fully reviewed by two authors. Review Manager 5 was used for statistical analysis and Cochrane Risk-of-bias tool for randomized trials was applied for quality assessment.
We included 2 studies, with 346 women, of whom 174 (50.2%) were treated with zuranolone. Zuranolone was significantly associated to an improvement of Clinical Global Impression response rate; Hamilton Depression Rating Scale 15 days and 45-day remission, 3-day, 15-day, and 45-day symptom remission, and reduction in the dose of antidepressants. As for safety outcomes, it was noticed that zuranolone increases sedation risk, which can be dose related. No significant differences were found for other adverse events.
These findings suggest that zuranolone might present a safe and effective medication for out-of-hospital treatment of PPD. Sedation effects need to be further assessed.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):275-282
Childbirth is a biological, psychological, and sociological event that can be a positive or negative experience, and, without support, this period may be potentially damaging. Parturition may distort maternal emotions and lead to short- or long-term disorders such as postpartum depression and anxiety. The present research aims to study the effects of dialectic behavioral therapy-based counseling on depression, anxiety symptoms, and postpartum hematocrit level.
The current research is a clinical trial study, and the sample was selected using parturients who were referred to the Health General Center with a diagnosis of postpartum depression and anxiety. The sample size consisted of 116 subjects who agreed to participate in the study. The patients in intervention group underwent group dialectic behavioral counseling (10 sessions/one session per week) and the control group did not receive any type of intervention. The patients were assessed in the first and last sessions as well as 2 months after the end of the sessions, using the Beck depression scale and Spielberg anxiety scale as well as the results of hematocrit tests. Data were analyzed using the IBMSPSS Statistics for Windows, Version 21.0 (IBMCorp., Armonk, NY, USA)
The results implied the effectiveness of dialectic behavioral therapy on reduction of the depression score, anxiety symptoms (p-value ≤ 0.0001), and hematocrit level (p-value=0.04). The participants’ depression, anxiety, and hematocrit levels decreased in the experiment group compared to the control group, and this decrease has remained until the 2-month follow-up.
It seems that dialectic behavioral counseling reduces the levels of postpartum depression, anxiety, and hematocrits.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):155-163
To evaluate the clinical epidemiological state of women with suspected post partum depression (PPD) in a public maternity hospital in Salvador, state of Bahia, Brazil.
A cross-sectional research was performed with puerperal patients attended at a public maternity hospital in Salvador, Bahia. Data collection was performed from June to September 2017. The Edinburgh Postnatal Depression Scale was used as a screening instrument, and, subsequently, women with positive scores answered a questionnaire to identify their clinical and epidemiological status.
Out of 151 postpartum women from the research, 30 (19.8%) presented suspicion of PPD. There was a prevalence of single mothers 13 (43.3%), women with complete fundamental education 15 (50.0%), women with black skin color 14 (46.7%), and those with a monthly family income of up to one minimum wage 18 (40.0%).
Although PPD is an underdiagnosed disease, a high prevalence of the condition was found in our research. It is, then, considered that these results reinforce its significance as a public health problem, requiring prevention strategies, early diagnosis and effective treatment.