Draft Research Plan
Draft Research Plan for Perinatal Depression: Interventions
This opportunity for public comment expired on June 15, 2016 at 8:00 PM EST
Note: This is a Draft Research Plan. This draft is distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF. The final Research Plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Review will form the basis of the USPSTF Recommendation Statement on this topic.
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Draft: Proposed Analytic Framework
Abbreviations: HrQoL = health-related quality of life; PPD = postpartum depression.
This figure is the analytic framework that depicts the two Key Questions to be addressed in the systematic review. The figure illustrates how interventions to prevent postpartum depression may result in improved health outcomes for both the mother and infant/child, including decreased incidence of postpartum depression; improved quality of life; improved psychosocial development; and decreased mortality, neglect, and abuse (KQ 1). Additionally, the figure depicts whether interventions to prevent postpartum depression are associated with any harms (KQ 2).
Draft: Proposed Key Questions to Be Systematically Reviewed
- Do interventions to prevent postpartum depression improve health outcomes among postpartum women and their infants?
- How are women identified as being at high risk of developing postpartum depression among trials that limit enrollment to high-risk women?
- What harms are associated with interventions to prevent postpartum depression among pregnant or postpartum women and their infants?
Draft: Proposed Contextual Questions
Contextual questions will not be systematically reviewed and are not shown in the Analytic Framework.
- Are there reliable and valid prognostic tools for identifying women who are at high risk of developing postpartum depression?
- When is the most effective time to intervene during pregnancy or the postpartum period to prevent postpartum depression?
Draft: Proposed Research Approach
The Proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions (KQs).
|Objective||Studies on interventions to prevent postpartum depression||Studies restricted to screening for and treatment of depression during pregnancy or in the postpartum period|
|Populations||Pregnant women and new mothers (≤12 weeks postpartum) of any age; may target women with mental health symptoms or disorders (see exceptions under exclusion criteria)||
Studies with mixed populations but more than 50% of the above populations will be excluded
|Interventions||Interventions to reduce the risk of postpartum depression, including:
||Active intervention (i.e., comparative effectiveness)|
|Outcomes||KQ 1: Maternal health outcomes
Infant/child health outcomes
|KQ 1: Maternal behavioral outcomes (e.g., increase in physical activity)|
|Timing of Outcome Assessment||KQ 1: Postdelivery to 12 months postpartum
KQ 2: Any time after intervention, up to 12 months postpartum
|KQ 1: During pregnancy and ≥12 months postpartum
KQ 2: ≥12 months postpartum
|Study designs||KQ 1: Randomized, controlled trials; controlled clinical trials
KQ 2: Systematic reviews; meta-analyses; randomized, controlled trials; controlled clinical trials; and large comparative cohort studies (for harms of antidepressant use only)
|All other study designs (e.g., case reports, case series)|
|Countries||Countries categorized as “very high” on the 2014 Human Development Index, as defined by the United Nations Development Programme||Countries not categorized as “very high” on the Human Development Index|
|Languages||English||Languages other than English|
|Quality||Fair or good, according to design-specific USPSTF criteria||Poor, according to design-specific USPSTF criteria|
Internet Citation: Draft Research Plan: Perinatal Depression: Interventions. U.S. Preventive Services Task Force. May 2016.