Summary of findings 2. Sertraline for the prevention of postnatal depression.
| Sertraline for the prevention of postnatal depression | ||||||
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Patient or population: women with a history of postnatal depression
Intervention: sertraline Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Selective serotonin reuptake inhibitors | |||||
| Postnatal depression (17 weeks) | 500 per 1000 | 70 per 1000 (10 to 535) | RR 0.14 (0.02 to 1.07) | 22 (1 study) | ⊕⊝⊝⊝ very low2,3 | |
| Adverse effects experienced by mother and/or fetus or nursing baby | 22 (1 study) | ⊕⊝⊝⊝ very low2,3 | 1 woman taking sertraline had a hypomanic episode. 2 side effects (dizziness and drowsiness) were more common among women taking sertraline than women taking placebo. |
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| Acceptability of treatment (17 weeks) | 22 (1 study) | ⊕⊝⊝⊝ very low2,3 | Acceptability of treatment was not assessed directly but no difference was found between the antidepressant and placebo groups in the number of women withdrawing from the study (P = 0.35, Fisher’s exact test). | |||
| Overall maternal satisfaction (17 weeks) | No data available | |||||
| Improvement in the maternal relationship with the baby (17 weeks) | No data available | |||||
| Establishment or continuation of breastfeeding (17 weeks) | No data available | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
1Assumed risk calculated as the proportion of women on placebo with the outcome (postnatal depression) multiplied by 1000
2Downgraded due to high risk of bias in 1 domain (incomplete outcome data) 3Downgraded twice due to imprecision (only 1 small study available for this comparison)