1 Depressive symptomatology at final study assessment (variously defined) Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Depressive symptomatology ‐ all trials

15

7697

Risk Ratio (M‐H, Random, 95% CI)

0.81 [0.65, 1.02]

1.2 Sensitivity analysis

9

3978

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.52, 1.12]

2 Depressive symptomatology at final study assessment (EPDS > 12) Show forest plot

10

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Depressive symptomatology ‐ all trials

10

6126

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.73, 1.15]

2.2 Sensitivity analysis

7

3667

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.75, 1.34]

3 Mean depression scores at final study assessment Show forest plot

8

Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Mean depression scores ‐ all trials

8

4880

Mean Difference (IV, Random, 95% CI)

‐0.36 [‐1.21, 0.48]

3.2 Sensitivity analysis

3

1107

Mean Difference (IV, Random, 95% CI)

0.23 [‐0.43, 0.89]

4 Depressive symptomatology at 8, 16, 24 weeks postpartum (variously defined) Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Depressive symptomatology at 0 to 8 weeks ‐ all trials

8

4091

Risk Ratio (M‐H, Random, 95% CI)

0.65 [0.43, 1.00]

4.2 Depressive symptomatology at 0 to 8 weeks ‐ sensitivity analysis

7

3575

Risk Ratio (M‐H, Random, 95% CI)

0.62 [0.38, 1.03]

4.3 Depressive symptomatology at 9 to 16 weeks ‐ all trials

8

3326

Risk Ratio (M‐H, Random, 95% CI)

0.80 [0.56, 1.12]

4.4 Depressive symptomatology at 9 to 16 weeks ‐ sensitivity analysis

6

1788

Risk Ratio (M‐H, Random, 95% CI)

0.87 [0.59, 1.28]

4.5 Depressive symptomatology at 17 to 24 weeks

7

4314

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.87, 1.19]

5 Depressive symptomatology at 8, 16, 24 weeks postpartum (EPDS > 12) Show forest plot

10

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

5.1 Depressive symptomatology at 0 to 8 weeks

6

3452

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.65, 1.25]

5.2 Depressive symptomatology at 9 to 16 weeks ‐ all trials

5

2369

Risk Ratio (M‐H, Random, 95% CI)

0.72 [0.49, 1.06]

5.3 Depressive symptomatology at 9 to 16 weeks ‐ sensitivity analysis

4

866

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.39, 1.28]

5.4 Depressive symptomatology at 17 to 24 weeks

6

3598

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.84, 1.19]

6 Maternal health service contact at final study assessment Show forest plot

1

190

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [0.57, 2.56]

6.1 Maternal health service contact

1

190

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [0.57, 2.56]

7 Maternal‐infant attachment at 8, 16, 24 weeks postpartum Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Maternal‐infant attachment at 0 to 8 weeks

1

174

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐1.18, 0.98]

7.2 Maternal‐infant attachment at 9 to 16 weeks

1

160

Mean Difference (IV, Fixed, 95% CI)

‐0.73 [‐1.84, 0.38]

8 Maternal attitudes toward motherhood at 8, 16, 24 weeks postpartum Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 Restriction of role at 0 to 8 weeks

1

174

Mean Difference (IV, Fixed, 95% CI)

‐0.13 [‐1.88, 1.62]

8.2 Restriction of role at 9 to 16 weeks

1

160

Mean Difference (IV, Fixed, 95% CI)

‐1.12 [‐2.95, 0.71]

9 Maternal anxiety at 8, 16, 24 weeks postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 Maternal anxiety at 0 to 8 weeks

1

114

Risk Ratio (M‐H, Fixed, 95% CI)

0.14 [0.05, 0.37]

10 Competence in mothering at 8 and 16 weeks postpartum Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

10.1 Maternal competence at 0 to 8 weeks

1

174

Mean Difference (IV, Fixed, 95% CI)

0.34 [‐1.68, 2.36]

10.2 Maternal competence at 9 to 16 weeks

1

160

Mean Difference (IV, Fixed, 95% CI)

‐1.46 [‐3.84, 0.92]

11 General physical and mental health (SF‐36) at final study assessment Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

11.1 Physical functioning

4

2589

Mean Difference (IV, Fixed, 95% CI)

0.29 [‐0.91, 1.49]

11.2 Role functioning (physical)

4

2588

Mean Difference (IV, Fixed, 95% CI)

‐0.90 [‐3.33, 1.52]

11.3 Bodily pain

4

2589

Mean Difference (IV, Fixed, 95% CI)

0.25 [‐1.41, 1.92]

11.4 Mental health

4

2582

Mean Difference (IV, Fixed, 95% CI)

‐0.85 [‐2.21, 0.52]

11.5 Role functioning (emotional)

4

2586

Mean Difference (IV, Fixed, 95% CI)

‐0.93 [‐3.55, 1.69]

11.6 Vitality

4

2581

Mean Difference (IV, Fixed, 95% CI)

0.64 [‐0.99, 2.28]

11.7 Social functioning

4

2591

Mean Difference (IV, Fixed, 95% CI)

‐0.59 [‐2.29, 1.10]

11.8 General health

4

2586

Mean Difference (IV, Fixed, 95% CI)

‐0.19 [‐1.68, 1.29]

12 Perceived social support at 8, 16, 24 weeks postpartum Show forest plot

2

Std. Mean Difference (IV, Fixed, 95% CI)

Subtotals only

12.1 Perceived social support at 0 to 8 weeks

1

513

Std. Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.16, 0.19]

12.2 Perceived social support at 9 to 16 weeks

1

732

Std. Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.15, 0.15]

12.3 Perceived social support at 17 to 24 weeks

2

1174

Std. Mean Difference (IV, Fixed, 95% CI)

0.02 [‐0.09, 0.14]

13 Breastfeeding duration at 8, 16, 24 weeks postpartum Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

13.1 Breastfeeding at 0 to 8 weeks

2

722

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.89, 1.19]

13.2 Breastfeeding at 9 to 16 weeks

2

635

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.76, 1.04]

13.3 Breastfeeding at 17 to 24 weeks

2

968

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.74, 1.10]

14 Infant immunisations Show forest plot

1

160

Mean Difference (IV, Fixed, 95% CI)

0.42 [0.11, 0.73]

14.1 Mean number of immunizations at 12 to 16 weeks

1

160

Mean Difference (IV, Fixed, 95% CI)

0.42 [0.11, 0.73]

15 Infant injuries Show forest plot

1

160

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.31, 0.92]

15.1 Infant injuries at 9 to 16 weeks

1

160

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.31, 0.92]

16 Marital discord at 4 and 24 weeks postpartum Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

16.1 Marital discord at 0 to 8 weeks

1

31

Mean Difference (IV, Fixed, 95% CI)

‐3.20 [‐16.93, 10.53]

16.2 Marital discord at 17 to 24 weeks

1

29

Mean Difference (IV, Fixed, 95% CI)

‐7.90 [‐21.52, 5.72]

1 Antenatal and postnatal classes Show forest plot

2

311

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.61, 1.72]

1.1 Depressive symptomatology at final study assessment

2

311

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.61, 1.72]

2 Postpartum professional‐based home visits Show forest plot

2

1663

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.55, 0.84]

2.1 Depressive symptomatology at final study assessment

2

1663

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.55, 0.84]

3 Postpartum lay‐based home visits Show forest plot

1

481

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.62, 1.27]

3.1 Depressive symptomatology at final study assessment

1

481

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.62, 1.27]

4 Early postpartum follow up Show forest plot

1

475

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.56, 1.48]

4.1 Depressive symptomatology at final study assessment

1

475

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.56, 1.48]

5 Continuity of care Show forest plot

1

935

Risk Ratio (M‐H, Fixed, 95% CI)

1.34 [0.97, 1.85]

5.1 Depressive symptomatology at final study assessment

1

935

Risk Ratio (M‐H, Fixed, 95% CI)

1.34 [0.97, 1.85]

1 Psychological debriefing Show forest plot

5

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Depressive symptomatology at final study assessment ‐ all trials

5

3051

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.31, 1.04]

1.2 Depressive symptomatology at final study assessment ‐ sensitivity analysis

4

2535

Risk Ratio (M‐H, Random, 95% CI)

0.51 [0.23, 1.14]

2 Interpersonal psychotherapy Show forest plot

2

72

Risk Ratio (M‐H, Random, 95% CI)

0.31 [0.04, 2.52]

2.1 Depressive symptomatology at final study assessment

2

72

Risk Ratio (M‐H, Random, 95% CI)

0.31 [0.04, 2.52]

1 Individually based interventions Show forest plot

11

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Depressive symptomatology at 0 to 8 weeks ‐ all trials

7

3963

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.40, 1.01]

1.2 Depressive symptomatology at 0 to 8 weeks ‐ sensitivity analysis

6

3447

Risk Ratio (M‐H, Random, 95% CI)

0.60 [0.34, 1.05]

1.3 Depressive symptomatology at 9 to 16 weeks ‐ all trials

4

2241

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.45, 1.12]

1.4 Depressive symptomatology at 9 to 16 weeks ‐ sensitivity analysis

3

738

Risk Ratio (M‐H, Random, 95% CI)

0.67 [0.31, 1.48]

1.5 Depressive symptomatology at 17 to 24 weeks

5

3484

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.82, 1.17]

1.6 Depressive symptomatology at final study assessment ‐ all trials

11

6642

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.59, 1.00]

1.7 Depressive symptomatology at final study assessment ‐ sensitivity analysis

7

3667

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.43, 1.09]

2 Group‐based interventions Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Depressive symptomatology at 0 to 8 weeks

1

128

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.31, 1.69]

2.2 Depressive symptomatology at 9 to 16 weeks ‐ all trials

4

1085

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.54, 1.59]

2.3 Depressive symptomatology at 9 to 16 weeks ‐ sensitivity analysis

3

1050

Risk Ratio (M‐H, Random, 95% CI)

1.08 [0.74, 1.57]

2.4 Depressive symptomatology at 17 to 24 weeks

2

830

Risk Ratio (M‐H, Random, 95% CI)

1.20 [0.85, 1.71]

2.5 Depressive symptomatology at final study assessment

4

1055

Risk Ratio (M‐H, Random, 95% CI)

1.03 [0.65, 1.63]

1 Interventions with antenatal and postnatal components Show forest plot

4

1283

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [0.93, 1.59]

1.1 Depressive symptomatology at final study assessment

4

1283

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [0.93, 1.59]

2 Interventions with postnatal only component Show forest plot

10

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Depressive symptomatology at final study assessment ‐ all trials

10

6379

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.58, 0.98]

2.2 Depressive symptomatology at final study assessment ‐ sensitivity analysis

5

2695

Risk Ratio (M‐H, Random, 95% CI)

0.56 [0.29, 1.06]

1 Single‐contact interventions Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Depressive symptomatology at 0 to 8 weeks

2

1756

Risk Ratio (M‐H, Random, 95% CI)

0.39 [0.07, 2.16]

1.2 Depressive symptomatology at 9 to 16 weeks

1

475

Risk Ratio (M‐H, Random, 95% CI)

1.21 [0.78, 1.85]

1.3 Depressive symptomatology at 17 to 24 weeks

3

2966

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.82, 1.26]

1.4 Depressive symptomatology at final study assessment ‐ all trials

4

2898

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.38, 1.27]

1.5 Depressive symptomatology at final study assessment ‐ sensitivity analysis

3

2432

Risk Ratio (M‐H, Random, 95% CI)

0.61 [0.26, 1.45]

2 Multiple‐contact interventions Show forest plot

11

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Depressive symptomatology at 0 to 8 weeks ‐ all trials

6

2274

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.50, 1.17]

2.2 Depressive symptomatology at 0 to 8 weeks ‐ sensitivity analysis

5

1758

Risk Ratio (M‐H, Random, 95% CI)

0.75 [0.44, 1.27]

2.3 Depressive symptomatology at 9 to 16 weeks ‐ all trials

7

2828

Risk Ratio (M‐H, Random, 95% CI)

0.72 [0.52, 1.01]

2.4 Depressive symptomatology at 9 to 16 weeks ‐ sensitivity analysis

5

1290

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.49, 1.17]

2.5 Depressive symptomatology at 17 to 24 weeks

4

1348

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.80, 1.31]

2.6 Depressive symptomatology at final study assessment ‐ all trials

11

4790

Risk Ratio (M‐H, Random, 95% CI)

0.84 [0.66, 1.08]

2.7 Depressive symptomatology at final study assessment ‐ sensitivity analysis

6

1546

Risk Ratio (M‐H, Random, 95% CI)

0.84 [0.53, 1.34]

1 Interventions for at‐risk women Show forest plot

7

1162

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.51, 0.89]

1.1 Depressive symptomatology at final study assessment

7

1162

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.51, 0.89]

2 Interventions for general population Show forest plot

8

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Depressive symptomatology at final study assessment ‐ all trials

8

6535

Risk Ratio (M‐H, Random, 95% CI)

0.87 [0.66, 1.16]

2.2 Depressive symptomatology at final study assessment ‐ sensitivity analysis

4

3367

Risk Ratio (M‐H, Random, 95% CI)

0.80 [0.45, 1.40]