Offspring outcomes after prenatal interventions for common mental disorders: a meta-analysis.

by Brouwer, Marlies E., Williams, Alishia D., van Grinsven, Sam E., Cuijpers, Pim, Lambregtse-van den Berg, Mijke P., Burger, Huibert and Bockting, Claudi L. H.
Abstract:
BACKGROUND: It is presumed that pharmacological and non-pharmacological treatment of prenatal common mental disorders can mitigate associated adverse effects in offspring, yet strong evidence for the prophylactic benefits of treatment is lacking. We therefore examined the effect of prenatal treatments for common mental disorders on offspring outcomes. METHODS: For this meta-analysis, articles published up to August 31, 2017, were obtained from PubMed, PsycInfo, Embase, and Cochrane databases. Included studies needed to be randomized controlled trials (RCTs) on the effect of treatment of prenatal common mental disorders comparing an intervention to a control condition, including offspring outcome(s). Random effects models were used to calculate Hedges’ g in the program Comprehensive Meta-Analysis(©) (version 3.0). RESULTS: Sixteen randomized controlled trials among 2778 pregnant women compared offspring outcomes between prenatal interventions and control groups. There were zero pharmacological, 13 psychological, and three other interventions (homeopathy, relaxation interventions, and short psycho-education). Birth weight (mean difference 42.88 g, g = 0.08, 95% CI -0.06 to 0.22, p = 0.27, n = 11), Apgar scores (g = 0.13, 95% CI -0.28 to 0.54, p = 0.53, n = 4), and gestational age (g = 0.03, 95% CI -0.06 to 0.54, p = 0.49, n = 10) were not significantly affected. Other offspring outcomes could not be meta-analyzed due to the inconsistent reporting of offspring outcomes and an insufficient number of studies. CONCLUSIONS: Non-pharmacological interventions had no significant effect on birth outcomes, although this outcome should be considered with caution due to the risk of biases. No randomized controlled trial examined the effects of prenatal pharmacological treatments as compared to treatment as usual for common mental disorders on offspring outcomes. Present clinical guidelines may require more research evidence on offspring outcomes, including child development, in order to warrant the current recommendation to routinely screen and subsequently treat prenatal common mental disorders. TRIAL REGISTRATION: PROSPERO CRD42016047190.
Reference:
Offspring outcomes after prenatal interventions for common mental disorders: a meta-analysis. (Brouwer, Marlies E., Williams, Alishia D., van Grinsven, Sam E., Cuijpers, Pim, Lambregtse-van den Berg, Mijke P., Burger, Huibert and Bockting, Claudi L. H.), In BMC medicine, volume 16, 2018.
Bibtex Entry:
@article{brouwer_offspring_2018,
	title = {Offspring outcomes after prenatal interventions for common mental disorders: a meta-analysis.},
	volume = {16},
	copyright = {All rights reserved},
	issn = {1741-7015},
	doi = {10.1186/s12916-018-1192-6},
	abstract = {BACKGROUND: It is presumed that pharmacological and non-pharmacological treatment of prenatal common mental disorders can mitigate associated adverse effects in  offspring, yet strong evidence for the prophylactic benefits of treatment is  lacking. We therefore examined the effect of prenatal treatments for common  mental disorders on offspring outcomes. METHODS: For this meta-analysis, articles  published up to August 31, 2017, were obtained from PubMed, PsycInfo, Embase, and  Cochrane databases. Included studies needed to be randomized controlled trials  (RCTs) on the effect of treatment of prenatal common mental disorders comparing  an intervention to a control condition, including offspring outcome(s). Random  effects models were used to calculate Hedges' g in the program Comprehensive  Meta-Analysis(©) (version 3.0). RESULTS: Sixteen randomized controlled trials  among 2778 pregnant women compared offspring outcomes between prenatal  interventions and control groups. There were zero pharmacological, 13  psychological, and three other interventions (homeopathy, relaxation  interventions, and short psycho-education). Birth weight (mean difference  42.88 g, g = 0.08, 95% CI -0.06 to 0.22, p = 0.27, n = 11), Apgar scores  (g = 0.13, 95% CI -0.28 to 0.54, p = 0.53, n = 4), and gestational age (g = 0.03,  95% CI -0.06 to 0.54, p = 0.49, n = 10) were not significantly affected. Other  offspring outcomes could not be meta-analyzed due to the inconsistent reporting  of offspring outcomes and an insufficient number of studies. CONCLUSIONS:  Non-pharmacological interventions had no significant effect on birth outcomes,  although this outcome should be considered with caution due to the risk of  biases. No randomized controlled trial examined the effects of prenatal  pharmacological treatments as compared to treatment as usual for common mental  disorders on offspring outcomes. Present clinical guidelines may require more  research evidence on offspring outcomes, including child development, in order to  warrant the current recommendation to routinely screen and subsequently treat  prenatal common mental disorders. TRIAL REGISTRATION: PROSPERO CRD42016047190.},
	language = {eng},
	number = {1},
	journal = {BMC medicine},
	author = {Brouwer, Marlies E. and Williams, Alishia D. and van Grinsven, Sam E. and Cuijpers, Pim and Lambregtse-van den Berg, Mijke P. and Burger, Huibert and Bockting, Claudi L. H.},
	month = nov,
	year = {2018},
	pmid = {30428883},
	pmcid = {PMC6237028},
	keywords = {Humans, Female, Pregnancy, *Depression, *Pregnancy, Child, *Antidepressant, *Anxiety, *Birth Weight, *Child, *Common mental disorders, *Gestational Age, *Offspring, *Prenatal interventions, *Psychotherapy, Mental Disorders/*therapy, Pregnancy Complications/*therapy, Young Adult},
	pages = {208},
}