NCHR Comment on USPSTF Draft Research Plan on Interventions to Prevent Perinatal Depression

March 22,  2023

We are pleased to have the opportunity to express our views regarding the USPSTF Draft Research Plan regarding Interventions to Prevent Perinatal Depression.

The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with a particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.

NCHR appreciates the task force’s efforts to address perinatal depression – one of the most common complications of pregnancy.¹ Perinatal depression contributes significantly to maternal mortality and adverse neonatal, infant, and child outcomes. Notably, suicide is a leading cause of death during the perinatal period in high-income countries, accounting for between 5 and 20% of maternal deaths. Therefore, developing effective interventions to prevent perinatal depression is essential in reducing high maternal mortality rates in the U.S.

We encourage the task force to include interventions that target loneliness and social isolation in its review. Studies show that loneliness can cause or worsen depression.² One qualitative meta-synthesis found that after pregnancy and childbirth, many women reported feeling disconnected from their usual social networks and identities. Some women described withdrawing from others due to fear of being seen as inadequate mothers. The study’s findings suggest that addressing loneliness may help prevent perinatal depression. We recommend that the task force includes in its review research on interventions that target loneliness to prevent perinatal depression. This may consist of providing opportunities and encouragement for social interactions or cognitive therapy to address factors that lead to self-isolation.

NCHR recommends that the task force also include studies of non-traditional interventions such as text-based screening and peer support programs. One example is the Healing at Home program at the Hospital of the University of Pennsylvania.³ This text-based program offers automated depression screening and alerts a clinician of elevated screening scores or affirmative answers about self-harm. The system increases the likelihood of earlier contact between patient and physician and facilitates prompt initiation of therapy or medical treatment when necessary. In addition, a 2020 systematic review of peer-support interventions for perinatal depression found that these programs reduced mean scores on standardized depression surveys and reduced the risk of depression.⁴

We thank you for the opportunity to comment on the USPSTF Draft Research Plan on Interventions to Prevent Perinatal Depression. NCHR strongly supports the task force’s efforts to find effective interventions to prevent perinatal depression and its dangerous consequences.

1. Howard LM, Khalifeh H. Perinatal mental health: a review of progress and challenges. World Psychiatry. 2020;19(3):313-327. doi:10.1002/wps.20769
2. Adlington K, Vasquez C, Pearce E, et al. ‘Just snap out of it’ – the experience of loneliness in women with perinatal depression: A Meta-synthesis of qualitative studies. BMC Psychiatry. 2023;23(1):110. doi:10.1186/s12888-023-04532-2
3. Penn Medicine Chatbot Screening Helps Identify Postpartum Depression – Penn Medicine. Accessed March 20, 2023. https://www.pennmedicine.org/news/news-blog/2022/july/penn-medicine-chatbot-screening-helps-identify-postpartum-depression
4. Huang R, Yan C, Tian Y, et al. Effectiveness of peer support intervention on perinatal depression: A systematic review and meta-analysis. J Affect Disord. 2020;276:788-796. doi:10.1016/j.jad.2020.06.048

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