Online psychological interventions to prevent perinatal depression in fathers or non-birthing partners: systematic review and meta-analysis of randomized controlled trials

Abstract

Paternal Perinatal Depression (PPD) is estimated to have an average prevalence of 8% to 13% in fathers during the perinatal period and has a negative impact on fathers’ well-being, family functioning, and child development. The purpose of this systematic review and meta-analysis (SR/MA) was to evaluate the effectiveness of online preventive interventions in non-birthing partners or fathers without depression or other mental disorders. PRISMA-DTA 2020 guidelines were followed. The search for eligible articles was conducted in PubMed, MEDLINE, PubMed, CINAHL Complete, PsycINFO, Scopus and Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), clinicalTrials.gov, Australian New Zealand Clinical Trial Registry, Beacon 2.0 and Psychotherapy Randomized Controlled and Comparative Trials. Grey literature in Opengrey was explored and experts in the field were asked for trial references or published studies. Selected RCTs involved non-birthing partners during the perinatal period (up to 12 months after childbirth). The results were a decrease in postpartum depressive symptoms and/or the incidence of PPD. Using random-effect models, the standardized mean difference (SMD) was computed. Sensitivity analysis were performed. A total of 6 RCTs were included in the SR-MA, conformed by 1752 participants, from five different countries. The pooled SMD was -0.258 [95% confidence interval (CI) -0.513 to -0.004; p < 0.001]. Heterogeneity was moderate (I2=51%). Only two RCTs had an overall low risk of bias. There were no available psychological online interventions delivered only for fathers or non-birthing partners, all were partner inclusive and their effect was not significant. Further RCTs with low risk of bias and specific fathers interventions to prevent PPD are needed.