Achievements

This study aimed to elucidate the status of preventive interventions during pregnancy for postpartum depression and the factors that influenced them. A web-based survey was administered to midwives (one from each facility), with six or more years of clinical experience, who worked in the obstetrics and gynecology wards of hospitals and clinics (2,161 facilities in total) that handled deliveries nationwide. Of the 390 collected copies (18.0% response rate), 374 valid responses were analyzed. A total of 241 (64.4%) facilities offered preventive interventions. Factors related to the implementation of preventive interventions were “state of conferences for emotional support  pregnant women” and “mental health screening in pregnancy settings.” Furthermore, for midwives’ perceptions, the factors included “need for preventive intervention,” “difficulty in allocating manpower,” “not resulting in revenue for the hospital,” and “lack of unity of intent within the hospital.” Preventive interventions during pregnancy were implemented in more than 60% of the facilities that handled deliveries. The study identified six factors that influenced their practices. To expand preventive interventions, focus on these issues was suggested.

A literature review on preventive intervention during pregnancy for postpartum depression was conducted to investigate intervention methods and their effects. Literature published from January 2001 to April 2021 was identified by searching the Icu-shi, CiNNi, and PubMed databases using the keywords “postpartum depression”,“pregnancy”, and “intervention or support”. The literature searched included original articles, research reports, and documents from studies conducted in Japan. Consequently, 14 studies were included in this analysis. The types of intervention included health teaching/interviews (six studies), group sessions (five studies), psychological education and training for requesting support (one study), and a program to promote fatal attachment (two studies). Considering the period of intervention, six studies were after 28 weeks of pregnancy, and four after the middle of pregnancy. Considering the evaluation of the intervention, 10 studies used the Edinburgh Postnatal Depression Scale, as well as other measures of anxiety and attachment. The intervention had a positive effect on depression at one month (six studies) and three months (two studies) postpartum, anxiety at one month postpartum (one study), and attachment (four studies). These results suggest that preventive intervention during pregnancy is effective in preventing postpartum depression. However, further research is needed to optimize the intervention methods.