Table 2.
Articles reporting on empowerment and perinatal depression
| Reference ID/Study authors | Study design | Sample | Measure of empowerment/intervention | Measure of depressive symptoms | Major findings | Quality rating/scorea |
|---|---|---|---|---|---|---|
| INTERVENTION STUDIES | ||||||
| [18] Liu et al. (2010) | Quasi-experimental | 70 parents of preterm newborns in Taiwan, 15 fathers, 55 mothers, M age = Intervention: 33.0 years, Control: 32.5 years | Parent-to-parent and parent-to-healthcare provider dialogue PP: 12 sessions over 8 months |
BDI-II PP: pre- and post-intervention |
Participating in dialogue w/lower post-intervention PPD symptoms, greater pre to post reduction in PPD symptoms, and greater childrearing self-efficacy | Fair (6) |
| [22] Pridham et al. (2005) | Randomized controlled trial | 42 US mother-premature infant pairs, 28 weeks post-conception, M age = GP: 25.5 years, Control: 26.17 years; predominantly European American and African American | GP – program to increase feeding competencies PP: weekly, biweekly, or monthly in first year |
CES-D PP: 1, 4, 8, 12 months |
No difference in PD symptoms; GP w/better ability to regulate infant negative affect and feeding behaviors | Good (9) |
| [12] Monthshki et al. (2013) | Randomized controlled trial | 230 women in Iran; 28–30 weeks’ GA, M age = Intervention: 28.0 years, Control: 27.8 years | Multidimensional Health Locus of Control PREG: 28–30 weeks’ GA PP: 4 weeks |
EPDS PP: 4 weeks PP |
Intervention w/increased internal health locus of control and lower PPD symptoms | Fair (7) |
| [23] Muzik et al. (2015) | Prospective cohort study | 80 US mother-child pairs M age = 23.7 years; Ethn: Caucasian 48.4%, African-American 44.1%, Biracial/Hispanic 7.5% | MP – parenting and self-care skills group program for high-risk mothers and their children PP: 13-weeks/sessions |
PDSS PP: pre- and post-intervention |
MP w/reduction in depression, post-traumatic stress disorder, and caregiving helplessness | Good (12) |
| [24] Ickovics et al. (2011) | Randomized controlled trial | 1047 US pregnant women, ages 14–25 (M = 20.4) years, 18 weeks’ GA; Ethn: 80% African-American, 13% Latina, 6% White, 1% Other; Note: Sample identical to [34], in Table 3 | CP, CP+ group w/additional HIV prevention information in last 3 sessions PREG and PP |
CES-D PREG: 2nd and 3rd trimester PP: 6, 12 months |
Initial high stress and CP+ group w/less PPD symptoms 1 year PP | Good (11) |
| [25] Kennedy et al. (2011) | Randomized controlled trial | 322 US pregnant women in the military, 12–16 weeks’ GA; M age = Control 25.5 years, CP: 24.0 years; Predominantly White, African American or Latina | CP PREG: 9 group sessions PP: one session |
CES-D; PDSS (PP only) PREG: baseline, 32–36 weeks’ GA PP: 3–4 months |
No differences in PD and PPD symptoms w/CP | Good (10) |
| [26] Melnyk et al. (2001) | Randomized controlled trial | 42 US mothers of premature infants, M age = COPE 26.6 years, Control, 28.8 years; Predominantly White or African American | COPE PP: 2–4 days after admission, 2–4 days thereafter, 1–2 days in NICU, 1–4 days before discharge, 7 days after discharge, 3 and 6 months |
POMS PP: at all phases and follow-up |
COPE w/less depressive symptoms after admission and before discharge, and w/higher infant cognitive development scores; No difference in mother’s overall mood state | Good (11) |
| [27] Melnyk et al. (2006) | Randomized controlled trial | 260 US families; 258 mothers (M age = 27.8 years) and 154 fathers with infant born at 26–34 weeks’ GA; Predominantly White or Black | COPE PP: 2–4 days after admission 2–4 days thereafter, 1–2 days in NICU, 1–4 days before discharge, 7 days thereafter |
BDI-II PP: at all times except NICU |
COPE w/lower post-hospital parental stress and depressive symptoms | Good (13) |
| [28] Melnyk et al. (2008) | Randomized controlled trial | 246 US mothers of LBW preterm infants, M age = 27.9 years, born at 26–34 (M = 31.4) weeks’ GA; Predominantly White or Black Note: Sample a subset of [27] | COPE PP: 2–4 days after admission, 2–4 days thereafter, 1–2 days in NICU, 1–4 days before discharge, 7 days thereafter |
BDI-II PP: 2–4 days after NICU admission, 2–4 days thereafter, and 2 months post-intervention |
COPE w/decreased post-hospital depression and anxiety symptoms | Good (13) |
| [29] Robertson et al. (2009) | Quasi-experimental | 49 Hispanic women, 24–26 weeks’ GA, M age = Control: 26.5 years, CP: 24.6 years | CP PREG: throughout pregnancy |
CES-D PP: not specified |
No difference in PD symptoms w/CP | Fair (5) |
| OBSERVATIONAL STUDIES | ||||||
| [14] O’Mahony et al. (2013) | Qualitative | 30 non-European immigrant and refugee women < 18 years old, living in Canada < 10 years, high risk for PPD | Relationship dominance and control, at time of interview PP: weeks not specified |
EPDS PREG and PP: within past 5 years and again at time of interview |
Emotional and economic relationship dominance by partner w/greater self-reported PPD vulnerability and symptoms | Fair (6) |
| [16] Richardson et al. (2012) | Cross-sectional | 126 US rural pregnant women, 18–50 years, mostly Caucasian | Levenson Scale on Locus of Control PREG: 20–28 weeks’ GA | EPDS PREG: 20–28 weeks’ GA |
Higher external locus of control w/higher PD scores; Internal locus of control w/lower PD | Fair (6) |
| [20] Gibson et al. (2015) | Cross- Sectional | 182 US pregnant and PP women, M age = 18.8 years; Ethn: 43% Hispanic, 38% African American, 15% White, 4% Other | Intimate partner violence w/CTS, Partner power w/Decision-Making Dominance Subscale of the SRPS PREG: 2nd or 3rd trimester PP: 6 months |
CES-D PP: 6 months |
PPD symptoms w/higher partner power and intimate partner violence | Good (9) |
| [30] Ali et al. (2009) | Longitudinal | 420 Pakistani pregnant women, M age = 26.1 years, 27.1% local, 72.9% immigrants | Unplanned pregnancy and domestic violence questionnaires PP: within 10 weeks pp |
Aga Khan University Anxiety and Depression Scale, DSM IV PP: consent, 1, 2, 6, 12 months |
Domestic violence and unplanned pregnancy w/higher PPD risk | Good (11) |
| [31] Rahman et al. (2012) | Longitudinal | 791 rural Pakistani women, M age = 26.8 years | Empowered to manage household finances: yes/no PREG: 3rd trimester PP: 6 months |
SCID, HRSD PREG: 3rd trimester PP: 6 months, 1 year |
Household debt and lack of empowerment to manage household finances w/PD and PPD | Good (11) |
| [32] Chien et al. (2012) | Cross-sectional | 380 immigrant women (M age = 27.06) from China and Vietnam, and native women (M age = 31.7) in Taiwan | Domestic decision-making power scale PP: 1–12 months |
EPDS PP: 1–12 months |
Low domestic decision-making power, family income, low social support and immigrant status w/higher PPD symptoms | Good (8) |
aQuality rating score is number of criteria met according to the National Institute of Health quality rating scale (range 0–14)
Studies are listed in order of their Reference Section ID Number
BDI-II Beck Depression Inventory-II, CES-D Center for Epidemiological Studies Depression Scale, COPE Creating Opportunities for Parent Empowerment, CP CenteringPregnancy, CTS Conflict Tactics Scale, EPDS Edinburg Postnatal Depression scale, Ethn Ethnicity, GA gestational age, GP guided participation, HRSD Hamilton Rating Scale for Depression, LBW low birthweight, M Mean, MP Mom Power, NICU neonatal infant care unit, PD perinatal depression, PDSS Postpartum Depression Screening Scale, POMS Profile of Mood States Scale, PP postpartum, PPD postpartum depression, PREG pregnancy, SCID Structured Clinical Interview for Depression, SRPS Sexual Relationship Power Scale, US United States, w/ with