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Intervenciones para prevenir la depresión perinatal: informe de evidencia y revisión sistemática para el grupo de
Elizabeth O'Connor1, Caitlyn A Senger1, Michelle L Henninger1
1Kaiser Permanente Research Affiliates Evidence-Based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|February 13, 2019
Resumen
Las intervenciones de asesoramiento previenen eficazmente la depresión perinatal, especialmente para las personas de alto riesgo. Si bien otros enfoques son prometedores, se necesita más investigación para establecer su eficacia y seguridad para el bienestar de la madre y el niño.
Área de la Ciencia:
- Salud mental perinatal
- Estrategias de salud preventivas
- Medicina basada en la evidencia
Sus antecedentes:
- La depresión perinatal afecta a las madres y a los bebés, por lo que se requieren estrategias eficaces de prevención.
- La atención primaria juega un papel crucial en la identificación y el manejo de la depresión perinatal.
Objetivo del estudio:
- Revisar sistemáticamente los beneficios y los daños de las intervenciones para prevenir la depresión perinatal.
- Informar las recomendaciones del Grupo de Trabajo de Servicios Preventivos de los Estados Unidos.
Principales métodos:
- Revisión sistemática de ensayos clínicos aleatorizados (ECA) y estudios de intervención controlada no aleatorizados.
- Buscado en las principales bases de datos incluyendo MEDLINE, PsycINFO, y Cochrane Central.
- Metaanálisis utilizado para estimar los beneficios de la intervención.
Principales resultados:
- Se incluyeron cincuenta estudios en los que participaron 22.385 personas.
- Las intervenciones de asesoramiento redujeron significativamente la probabilidad de depresión perinatal (RR, 0,61).
- Las intervenciones del sistema de salud mostraron un beneficio potencial, pero no fueron estadísticamente significativas; el uso de antidepresivos tuvo resultados mixtos con respecto a la recurrencia y los efectos adversos.
Conclusiones:
- Las intervenciones de asesoramiento son efectivas en la prevención de la depresión perinatal, especialmente para las poblaciones en riesgo.
- Otras intervenciones muestran potencial pero requieren una investigación más sólida.
- La evidencia apoya la integración de estrategias preventivas en la atención primaria para la salud mental perinatal.
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