NICU-based interventions to reduce maternal depressive and anxiety symptoms: A meta-analysis

Context: parents whose infants are being treated in the nicu are at high risk for depression abstract and anxiety, with negative implications for parenting and infant development. objective: we conducted a systematic review and meta-analysis of nicu-based interventions to reduce maternal depressive or anxiety symptoms. data sources: pubmed, embase, psychinfo, cochrane, and cinahl were searched for relevant studies. reference lists from selected studies were reviewed. study selection: inclusion criteria included randomized controlled design, a parent-focused intervention delivered in the nicu, valid maternal depressive or anxiety symptom measures at pre-and postintervention, and publication in a peer-reviewed journal in english. data extraction: data extraction was conducted independently by 2 coders. results: twelve studies met inclusion criteria for qualitative review; 2 were excluded from quantitative analyses for high risk of bias. fixed-and random-effects models, with 7 eligible studies assessing depressive symptoms, indicated an effect of -0.16 (95% confidence interval [ci], -0.32 to -0.002; p < .05) and, with 8 studies assessing anxiety symptoms, indicated an effect of -0.12 (95% ci, -0.29 to 0.05; p = .17). the subset of interventions using cognitive behavioral therapy significantly reduced depressive symptoms (effect, -0.44; 95% ci, -0.77 to -0.11; p = .01). limitations: the small number and methodological shortcomings of studies limit conclusions regarding intervention effects. conclusions: combined intervention effects significantly reduced maternal depressive but not anxiety symptoms. the evidence is strongest for the impact of cognitive behavioral therapy interventions on maternal depressive symptoms.