1 Depressive symptomatology at final study assessment Show forest plot

20

14727

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.66, 0.93]

2 Mean depression scores at final study assessment Show forest plot

19

12376

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

‐0.13 [‐0.28, 0.01]

3 Diagnosis of depression at final study assessment Show forest plot

5

939

Risk Ratio (M‐H, Random, 95% CI)

0.50 [0.32, 0.78]

4 Depressive symptomatology at 8, 16, 24, and > 24 weeks Show forest plot

20

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Immediate outcomes 0‐8 weeks

13

4907

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.56, 0.95]

4.2 Short‐term outcome 9‐16 weeks

10

3982

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.56, 0.97]

4.3 Intermediate outcome 17‐24 weeks

9

10636

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.82, 1.05]

4.4 Long‐term outcome > 24 weeks

5

2936

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.54, 0.82]

5 Mean depression scores at 8, 16, 24, and > 24 weeks Show forest plot

19

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

Subtotals only

5.1 Immediate outcomes: 0‐8 weeks

6

1234

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

‐0.16 [‐0.41, 0.09]

5.2 Short‐term outcome 9‐16 weeks

9

3628

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

‐0.26 [‐0.72, 0.20]

5.3 Intermediate outcome 17‐24 weeks

10

9944

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

0.01 [‐0.03, 0.05]

5.4 Long‐term outcome > 24 weeks

7

2447

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

‐0.17 [‐0.58, 0.25]

6 Diagnosis of depression at 8, 16, 24, and > 24 weeks Show forest plot

5

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Immediate outcomes 0‐8 weeks

1

39

Risk Ratio (M‐H, Random, 95% CI)

0.09 [0.01, 1.47]

6.2 Short‐term outcomes 9‐16 weeks postpartum

4

902

Risk Ratio (M‐H, Random, 95% CI)

0.49 [0.31, 0.77]

6.3 Intermediate outcome: 17‐24 weeks

1

37

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.17, 2.46]

7 Maternal mortality at > 24 weeks Show forest plot

1

234

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.06, 15.27]

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

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

8.1 Immediate outcomes 0‐8 weeks

1

133

Risk Ratio (M‐H, Random, 95% CI)

1.01 [0.64, 1.59]

8.2 Short‐term outcome 9‐16 weeks

1

126

Risk Ratio (M‐H, Random, 95% CI)

1.29 [0.78, 2.13]

8.3 Intermediate outcome 17‐24 weeks

1

127

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.59, 1.34]

9 Mean maternal‐infant attachment scores at 8, 16, 24, and > 24 weeks Show forest plot

2

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

Subtotals only

9.1 Immediate outcomes 0‐8 weeks

1

176

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

‐0.11 [‐0.40, 0.19]

9.2 Short‐term outcome 9‐16 weeks

1

160

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

‐0.20 [‐0.51, 0.11]

9.3 Intermediate outcome 17‐24 weeks

1

152

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

‐0.22 [‐0.54, 0.10]

9.4 Long‐term outcome > 24 weeks

1

116

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

‐0.12 [‐0.49, 0.24]

9.5 At final study assessment

2

268

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

‐0.18 [‐0.42, 0.06]

10 Anxiety at 8, 16, and 24 weeks Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

10.1 Immediate outcomes 0‐8 weeks

2

245

Risk Ratio (M‐H, Random, 95% CI)

0.35 [0.05, 2.34]

10.2 Short‐term outcome 9‐16 weeks

3

843

Risk Ratio (M‐H, Random, 95% CI)

0.41 [0.12, 1.41]

10.3 Intermediate outcome 17‐24 weeks

1

130

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.25, 3.60]

10.4 At final study assessment

4

959

Risk Ratio (M‐H, Random, 95% CI)

0.40 [0.14, 1.14]

11 Mean anxiety scores at 8, 16, 24, and > 24 weeks Show forest plot

4

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

Subtotals only

11.1 Immediate outcomes 0‐8 weeks

2

163

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

‐0.09 [‐0.39, 0.22]

11.2 Short‐term outcome 9‐16 weeks

2

740

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

‐0.15 [‐0.30, ‐0.01]

11.3 Intermediate outcome 17‐24 weeks

2

160

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

‐0.24 [‐0.55, 0.07]

11.4 Long‐term outcome > 24 weeks

1

43

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

‐0.17 [‐0.77, 0.43]

11.5 At final study assessment

4

815

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

‐0.16 [‐0.30, ‐0.03]

12 Maternal stress at 16 weeks Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

12.1 Short‐term outcome 9‐16 weeks

1

103

Risk Ratio (M‐H, Random, 95% CI)

0.44 [0.20, 0.96]

13 Mean maternal stress scores at 24 and > 24 weeks Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

13.1 Intermediate outcome 17‐24 weeks

1

787

Mean Difference (IV, Random, 95% CI)

0.0 [‐1.02, 1.02]

13.2 Long‐term outcome > 24 weeks

1

840

Mean Difference (IV, Random, 95% CI)

0.5 [‐0.51, 1.51]

14 Mean parental stress scores at 8, 24, and > 24 weeks Show forest plot

3

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

Subtotals only

14.1 Immediate outcomes 0‐8 weeks

1

176

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

‐0.08 [‐0.37, 0.22]

14.2 Intermediate outcome 17‐24 weeks

1

124

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

‐0.27 [‐0.62, 0.09]

14.3 Long‐term outcome > 24 weeks

2

341

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

0.27 [0.05, 0.48]

14.4 At final study assessment

3

465

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

0.11 [‐0.25, 0.48]

15 Perceived social support at 8 and 16 weeks Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

15.1 Immediate outcomes 0‐8 weeks

1

528

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.45, 1.05]

15.2 Short‐term outcome 9‐16 weeks

1

190

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.34, 3.05]

15.3 At final study assessment

2

718

Risk Ratio (M‐H, Random, 95% CI)

0.72 [0.48, 1.08]

16 Mean perceived social support scores at 8, 16, 24, and > 24 weeks Show forest plot

7

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

Subtotals only

16.1 Immediate outcomes 0‐8 weeks

3

822

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

0.02 [‐0.13, 0.17]

16.2 Short‐term outcome 9‐16 weeks

2

863

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

0.16 [‐0.21, 0.53]

16.3 Intermediate outcome 17‐24 weeks

6

8122

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

0.03 [‐0.06, 0.12]

16.4 Long‐term outcome > 24 weeks

2

955

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

‐0.07 [‐0.20, 0.06]

16.5 At final study assessment

7

8290

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

0.01 [‐0.08, 0.10]

17 Maternal dissatisfaction with care provided at 8, 16, and 24 weeks Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

17.1 Immediate outcomes 0‐8 weeks

2

825

Risk Ratio (M‐H, Random, 95% CI)

0.56 [0.29, 1.09]

17.2 Short‐term outcome 9‐16 weeks

1

1278

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.65, 1.19]

17.3 Intermediate outcome 17‐24 weeks

1

911

Risk Ratio (M‐H, Random, 95% CI)

0.75 [0.44, 1.25]

17.4 At final study assessment

4

3014

Risk Ratio (M‐H, Random, 95% CI)

0.67 [0.44, 1.00]

18 Mean maternal dissatisfaction scores at 8 and 16 weeks Show forest plot

2

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

Subtotals only

18.1 Immediate outcomes 0‐8 weeks

1

516

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

0.0 [‐0.17, 0.17]

18.2 Short‐term outcome 9‐16 weeks

1

160

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

0.90 [0.58, 1.23]

18.3 At final study assessment

2

676

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

0.44 [‐0.44, 1.32]

19 Infant health parameters ‐ not fully immunized at > 24 weeks Show forest plot

1

884

Risk Ratio (M‐H, Random, 95% CI)

1.16 [0.39, 3.43]

20 Infant development > 24 weeks Show forest plot

1

280

Mean Difference (IV, Random, 95% CI)

‐0.90 [‐2.90, 1.10]

20.1 Bayley (BSID‐II)

1

280

Mean Difference (IV, Random, 95% CI)

‐0.90 [‐2.90, 1.10]

21 Child abuse at 8 and > 24 weeks Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

21.1 Immediate outcomes 0‐8 weeks

1

176

Mean Difference (IV, Random, 95% CI)

‐35.66 [‐62.65, ‐8.67]

21.2 Long‐term outcome > 24 weeks

1

66

Mean Difference (IV, Random, 95% CI)

‐41.90 [‐87.48, 3.68]

22 Mean marital discord scores at 8, 16, and 24 weeks Show forest plot

3

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

Subtotals only

22.1 Immediate outcomes 0‐8 weeks

2

163

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

‐0.03 [‐0.34, 0.28]

22.2 Short‐term outcome 9‐16 weeks

1

127

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

‐0.28 [‐0.63, 0.07]

22.3 Intermediate outcome 17‐24 weeks

3

291

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

‐0.14 [‐0.37, 0.09]

22.4 At final study assessment

3

291

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

‐0.14 [‐0.37, 0.09]

1 All psychosocial interventions ‐ depressive symptomatology Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Immediate outcome ‐ 0‐8 weeks

6

2138

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.52, 1.14]

1.2 Short‐term outcomes 9‐16 weeks

8

3705

Risk Ratio (M‐H, Random, 95% CI)

0.80 [0.61, 1.06]

1.3 Intermediate outcomes 17‐24 weeks

6

8116

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.78, 1.00]

1.4 Long‐term outcomes >24 weeks

3

1385

Risk Ratio (M‐H, Random, 95% CI)

0.59 [0.46, 0.76]

1.5 At final study assessment

12

11322

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.70, 0.99]

2 All psychosocial interventions ‐ mean depression scores Show forest plot

12

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

Subtotals only

2.1 Immediate outcomes 0‐8 weeks

3

849

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

‐0.12 [‐0.47, 0.23]

2.2 Short‐term outcomes 9‐16 weeks

6

3333

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

‐0.32 [‐0.90, 0.25]

2.3 Intermediate outcomes 17‐24 weeks

8

8998

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

0.00 [‐0.04, 0.05]

2.4 Long‐term outcomes > 24 weeks

5

2254

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

‐0.26 [‐0.76, 0.24]

2.5 At final study assessment

12

10944

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

‐0.14 [‐0.33, 0.04]

3 All psychosocial interventions ‐ diagnosis of depression Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Short‐term outcomes 9‐16 weeks

3

867

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.33, 0.83]

4 All psychosocial interventions: depressive symptomatology at final study assessment Show forest plot

12

11322

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.70, 0.99]

5 All psychosocial interventions: mean depression scores Show forest plot

12

10944

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

‐0.14 [‐0.33, 0.04]

1 All psychological interventions ‐ depressive symptomatology Show forest plot

8

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Immediate outcomes 0‐8 weeks

7

2760

Risk Ratio (M‐H, Random, 95% CI)

0.69 [0.47, 1.02]

1.2 Short‐term outcomes 9‐16 weeks

2

277

Risk Ratio (M‐H, Random, 95% CI)

0.40 [0.18, 0.89]

1.3 Intermediate outcomes 17‐24 weeks

3

2520

Risk Ratio (M‐H, Random, 95% CI)

1.04 [0.83, 1.30]

1.4 Long‐term outcomes >24 weeks

2

1551

Risk Ratio (M‐H, Random, 95% CI)

0.86 [0.58, 1.28]

1.5 At final study assessment

8

3405

Risk Ratio (M‐H, Random, 95% CI)

0.61 [0.39, 0.96]

2 All psychological interventions ‐ mean depression scores Show forest plot

7

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

Subtotals only

2.1 immediate outcome 0‐8 weeks

3

385

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

‐0.20 [‐0.63, 0.22]

2.2 Short‐term outcomes 9‐16 weeks

3

295

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

‐0.03 [‐0.27, 0.21]

2.3 Intermediate outcomes 17‐24 weeks

2

946

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

0.08 [‐0.05, 0.20]

2.4 Long‐term outcomes > 24 weeks

2

193

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

0.11 [‐0.17, 0.39]

2.5 At final study assessment

7

1432

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

‐0.10 [‐0.32, 0.13]

3 All psychological interventions ‐ diagnosis of depression Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Diagnosis of depression ‐ 0‐8 weeks

1

39

Risk Ratio (M‐H, Random, 95% CI)

0.09 [0.01, 1.47]

3.2 Short‐term outcomes 9‐16 weeks

1

35

Risk Ratio (M‐H, Random, 95% CI)

0.08 [0.00, 1.34]

3.3 Intermediate outcomes 17‐24 weeks

1

37

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.17, 2.46]

3.4 At final study assessment

2

72

Risk Ratio (M‐H, Random, 95% CI)

0.31 [0.04, 2.52]

1 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology at final study assessment Show forest plot

12

11322

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.70, 0.99]

1.1 Antenatal and postnatal classes

4

1488

Risk Ratio (M‐H, Random, 95% CI)

1.01 [0.77, 1.32]

1.2 Postpartum professional‐based home visits

2

1262

Risk Ratio (M‐H, Random, 95% CI)

0.56 [0.43, 0.73]

1.3 Postpartum lay‐based home visits

1

493

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.62, 1.25]

1.4 Postpartum lay‐based telephone support

1

612

Risk Ratio (M‐H, Random, 95% CI)

0.54 [0.38, 0.77]

1.5 Early postpartum follow‐up

1

446

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.55, 1.49]

1.6 Continuity model of care

3

7021

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.71, 1.36]

2 TEST FOR SUBGROUP DIFFERENCES: mean depression score at final study assessment Show forest plot

4

1411

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

‐0.01 [‐0.12, 0.10]

2.1 Antenatal and postnatal classes

3

1124

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

0.01 [‐0.11, 0.13]

2.2 Antenatal and postnatal lay‐based home visits and telephone support

1

287

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

‐0.10 [‐0.33, 0.14]

1 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology at final study assessment Show forest plot

6

3200

Risk Ratio (M‐H, Random, 95% CI)

0.59 [0.35, 1.01]

1.1 Psychological debriefing

5

3050

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.31, 1.03]

1.2 Cognitive behavioural therapy

1

150

Risk Ratio (M‐H, Random, 95% CI)

0.74 [0.29, 1.88]

2 TEST FOR SUBGROUP DIFFERENCES: mean depression score at final study assessment Show forest plot

6

516

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

‐0.16 [‐0.43, 0.11]

2.1 Interpersonal psychotherapy

5

366

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

‐0.27 [‐0.52, ‐0.01]

2.2 Cognitive behavioural therapy

1

150

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

0.13 [‐0.20, 0.45]

1 Professionally‐based interventions ‐ depressive symptomatology Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Immediate outcomes 0‐8 weeks

10

3699

Risk Ratio (M‐H, Random, 95% CI)

0.65 [0.45, 0.93]

1.2 Short‐term outcome 9‐16 weeks

8

3196

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.57, 1.09]

1.3 Intermediate outcome 17‐24 weeks

7

3929

Risk Ratio (M‐H, Random, 95% CI)

1.03 [0.87, 1.23]

1.4 Long‐term outcome > 24 weeks

4

2786

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.51, 0.90]

2 Professionally‐based interventions ‐ mean depression scores Show forest plot

12

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

Subtotals only

2.1 Immediate outcomes: 0‐8 weeks

4

512

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

‐0.34 [‐0.56, ‐0.12]

2.2 Short‐term outcome 9‐16 weeks

6

2807

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

‐0.31 [‐0.95, 0.34]

2.3 Intermediate outcome 17‐24 weeks

7

3161

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

0.02 [‐0.05, 0.09]

2.4 Long‐term outcome >24 weeks

5

2010

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

‐0.24 [‐0.79, 0.31]

3 Professionally‐based interventions ‐ diagnosis of depression Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Immediate outcomes 0‐8 weeks

1

39

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 1.47]

3.2 Short‐term outcomes 9‐16 weeks postpartum

1

190

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.13, 1.98]

3.3 Intermediate outcome: 17‐24 weeks

1

37

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.17, 2.46]

4 Lay‐based interventions ‐ depressive symptomatology Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Immediate outcomes 0‐8 weeks

3

1208

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.70, 1.18]

4.2 Short‐term outcome 9‐16 weeks

2

786

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.40, 0.75]

4.3 Intermediate outcome 17‐24 weeks

1

493

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.62, 1.25]

4.4 Long‐term outcome > 24 weeks

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.29, 1.88]

5 Lay‐based interventions ‐ mean depression scores Show forest plot

5

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

Subtotals only

5.1 Immediate outcomes: 0‐8 weeks

2

722

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

0.11 [‐0.04, 0.25]

5.2 Short‐term outcome 9‐16 weeks

2

786

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

‐0.08 [‐0.35, 0.19]

5.3 Intermediate outcome 17‐24 weeks

2

633

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

‐0.06 [‐0.22, 0.09]

5.4 Long‐term outcome > 24 weeks

2

437

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

‐0.01 [‐0.22, 0.20]

6 Lay‐based interventions ‐ diagnosis of depression Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Short‐term outcomes 9‐16 weeks postpartum

2

677

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.32, 0.86]

7 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology: at final study assessment Show forest plot

19

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

7.1 Professionally‐based interventions

15

6790

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.60, 1.00]

7.2 Lay‐based interventions

4

1723

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.54, 0.90]

8 TEST FOR SUBGROUP DIFFERENCES: mean depression scores: at final study assessment Show forest plot

17

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

Subtotals only

8.1 Professionally‐based interventions

12

4509

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

‐0.15 [‐0.40, 0.10]

8.2 Lay‐based interventions

5

1682

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

‐0.10 [‐0.20, 0.01]

9 TEST FOR SUBGROUP DIFFERENCES: diagnosis of depression: at final study assessment Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 Professionally‐based interventions

2

227

Risk Ratio (M‐H, Fixed, 95% CI)

0.56 [0.22, 1.47]

9.2 Lay‐based interventions

2

677

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.32, 0.86]

1 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology at final study assessment Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Intervention provided by nurses

3

837

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.51, 1.04]

1.2 Intervention provided by physicians

1

446

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.55, 1.49]

1.3 Intervention provided by midwives

10

5477

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.54, 1.07]

1.4 Intervention provided by mental health specialists

1

30

Risk Ratio (M‐H, Random, 95% CI)

1.0 [0.24, 4.18]

2 TEST FOR SUBGROUP DIFFERENCES: mean depression score at final study assessment Show forest plot

4

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

Subtotals only

2.1 Intervention provided by nurses

1

86

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

‐0.08 [‐0.51, 0.34]

2.2 Intervention provided by midwives

1

840

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

0.05 [‐0.09, 0.19]

2.3 Intervention provided by mental health specialists

2

175

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

0.04 [‐0.26, 0.34]

1 Individually‐based interventions ‐ depressive symptomatology Show forest plot

14

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Immediate outcomes 0‐8 weeks

9

3947

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.49, 1.00]

1.2 Short‐term outcomes 9‐16 weeks

6

2757

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.47, 0.91]

1.3 Intermediate outcomes 17‐24 weeks

7

9806

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.80, 0.98]

1.4 Long‐term outcomes > 24 weeks

4

2786

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.51, 0.90]

2 Individually‐based interventions ‐ mean depression scores Show forest plot

11

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

Subtotals only

2.1 Immediate outcomes 0‐8 weeks

4

882

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

‐0.11 [‐0.41, 0.19]

2.2 Short‐term outcomes 9‐16 weeks

5

2601

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

‐0.40 [‐1.07, 0.26]

2.3 Intermediate outcomes 17‐24 weeks

6

8156

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

0.01 [‐0.03, 0.05]

2.4 Long‐term outcomes > 24 weeks

5

1457

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

‐0.28 [‐0.78, 0.23]

3 Individually‐based interventions ‐ diagnosis of depression Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Immediate outcomes 0‐8 weeks

1

39

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 1.47]

3.2 Short‐term outcomes 9‐16 weeks

2

677

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.32, 0.86]

3.3 Intermediate outcomes 17‐24 weeks

1

37

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.17, 2.46]

4 Group‐based interventions ‐ depressive symptomatology Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Immediate outcomes 0‐8 weeks

4

946

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.45, 0.91]

4.2 Short‐term outcomes 9‐16 weeks

4

1225

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.60, 1.39]

4.3 Intermediate outcomes 17‐24 weeks

2

830

Risk Ratio (M‐H, Random, 95% CI)

1.20 [0.85, 1.71]

4.4 Long‐term outcomes > 24 weeks

1

150

Risk Ratio (M‐H, Random, 95% CI)

0.74 [0.29, 1.88]

5 Group‐based interventions ‐ mean depression scores Show forest plot

8

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

Subtotals only

5.1 Immediate outcomes 0‐8 weeks

2

352

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

‐0.24 [‐0.80, 0.31]

5.2 Short‐term outcomes 9‐16 weeks

4

1027

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

0.04 [‐0.09, 0.16]

5.3 Intermediate outcomes 17‐24 weeks

4

1788

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

0.01 [‐0.08, 0.11]

5.4 Long‐term outcomes > 24 weeks

2

990

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

0.06 [‐0.07, 0.19]

6 Group‐based interventions ‐ diagnosis of depression Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Short‐term outcomes 9‐16 weeks

2

225

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.05, 1.66]

7 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology: at final study assessment Show forest plot

20

14727

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.66, 0.93]

7.1 Individually‐based interventions

14

12914

Risk Ratio (M‐H, Random, 95% CI)

0.75 [0.61, 0.92]

7.2 Group‐based interventions

6

1813

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.71, 1.19]

8 TEST FOR SUBGROUP DIFFERENCES: mean depression scores: at final study assessment Show forest plot

19

12376

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

‐0.13 [‐0.28, 0.01]

8.1 Individually‐based interventions

11

10092

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

‐0.15 [‐0.37, 0.07]

8.2 Group‐based interventions

8

2284

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

‐0.08 [‐0.23, 0.06]

9 TEST FOR SUBGROUP DIFFERENCES: diagnosis of depression: at final study assessment Show forest plot

5

939

Risk Ratio (M‐H, Random, 95% CI)

0.50 [0.32, 0.78]

9.1 Individually‐based interventions

3

714

Risk Ratio (M‐H, Random, 95% CI)

0.53 [0.33, 0.84]

9.2 Group‐based interventions

2

225

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.05, 1.66]

1 Single‐contact interventions ‐ depressive symptomatology Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Immediate outcomes 0‐8 weeks

2

1756

Risk Ratio (M‐H, Random, 95% CI)

0.39 [0.07, 2.16]

1.2 Short‐term outcomes 9‐16 weeks

1

476

Risk Ratio (M‐H, Random, 95% CI)

1.24 [0.81, 1.91]

1.3 Intermediate outcomes 17‐24 weeks

3

2936

Risk Ratio (M‐H, Random, 95% CI)

1.01 [0.82, 1.26]

1.4 Long‐term outcomes > 24 weeks

1

1401

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.58, 1.37]

2 Single‐contact interventions ‐ mean depression scores Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 Short‐term outcomes 9‐16 weeks

1

476

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐1.06, 0.86]

2.2 Intermediate outcomes 17‐24 weeks

2

1362

Mean Difference (IV, Fixed, 95% CI)

0.21 [‐0.37, 0.79]

3 Multiple‐contact interventions ‐ depressive symptomatology Show forest plot

16

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Immediate outcomes 0‐8 weeks

11

3137

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.60, 0.99]

3.2 Short‐term outcomes 9‐16 weeks

9

3506

Risk Ratio (M‐H, Random, 95% CI)

0.69 [0.52, 0.91]

3.3 Intermediate outcomes 17‐24 weeks

6

7700

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.77, 1.01]

3.4 Long‐term outcomes > 24 weeks

4

1535

Risk Ratio (M‐H, Random, 95% CI)

0.60 [0.47, 0.76]

4 Multiple‐contact interventions ‐ mean depression scores Show forest plot

17

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

Subtotals only

4.1 Immediate outcomes 0‐8 weeks

6

1234

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

‐0.16 [‐0.41, 0.09]

4.2 Short‐term outcomes 9‐16 weeks

8

3152

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

‐0.30 [‐0.81, 0.22]

4.3 Intermediate outcomes 17‐24 weeks

8

8582

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

0.01 [‐0.04, 0.05]

4.4 Long‐term outcomes > 24 weeks

7

2447

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

‐0.17 [‐0.58, 0.25]

5 Multiple‐contact interventions ‐ diagnosis of depression Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Immediate outcomes 0‐8 weeks

1

39

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 1.47]

5.2 Short‐term outcomes 9‐16 weeks

4

902

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.30, 0.74]

5.3 Intermediate outcomes 17‐24 weeks

1

37

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.17, 2.46]

5.4 At final study assessment

5

939

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.31, 0.74]

6 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology: at final study assessment Show forest plot

20

14727

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.66, 0.93]

6.1 Single contact intervention

4

2877

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.38, 1.28]

6.2 Multiple contact intervention

16

11850

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.66, 0.93]

7 TEST FOR SUBGROUP DIFFERENCES: mean depression scores: at final study assessment Show forest plot

19

12376

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

‐0.13 [‐0.28, 0.01]

7.1 Single contact intervention

2

1362

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

0.04 [‐0.07, 0.15]

7.2 Multiple contact intervention

17

11014

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

‐0.15 [‐0.32, 0.02]

1 Interventions with antenatal only component ‐ mean depression scores Show forest plot

4

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

Subtotals only

1.1 Short‐term outcomes 9‐16 weeks

1

35

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

‐0.44 [‐1.11, 0.23]

1.2 Intermediate outcomes 17‐24 weeks

2

919

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

0.06 [‐0.07, 0.19]

1.3 Long‐term outcomes > 24 weeks

2

883

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

0.05 [‐0.09, 0.19]

2 Interventions with antenatal only component ‐ diagnosis of depression Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Short‐term outcomes 9‐16 weeks

1

35

Risk Ratio (M‐H, Fixed, 95% CI)

0.08 [0.00, 1.34]

3 Interventions with antenatal and postnatal components ‐ depressive symptomatology Show forest plot

8

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Immediate outcomes 0‐8 weeks

7

1794

Risk Ratio (M‐H, Random, 95% CI)

0.75 [0.52, 1.08]

3.2 Short‐term outcomes 9‐16 weeks

4

621

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.45, 0.97]

3.3 Intermediate outcomes 17‐24 weeks

3

284

Risk Ratio (M‐H, Random, 95% CI)

0.87 [0.41, 1.85]

3.4 Long‐term outcomes > 24 weeks

2

273

Risk Ratio (M‐H, Random, 95% CI)

0.82 [0.46, 1.46]

4 Interventions with antenatal and postnatal components ‐ mean depression scores Show forest plot

7

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

Subtotals only

4.1 Immediate outcomes 0‐8 weeks

4

518

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

‐0.18 [‐0.47, 0.11]

4.2 Short‐term outcomes 9‐16 weeks

3

388

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

‐0.05 [‐0.25, 0.15]

4.3 Intermediate outcomes 17‐24 weeks

3

315

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

‐0.22 [‐0.45, ‐0.00]

4.4 Long‐term outcomes > 24 weeks

3

560

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

‐0.03 [‐0.20, 0.13]

5 Interventions with antenatal and postnatal components ‐ diagnosis of depression Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Immediate outcomes 0‐8 weeks

1

39

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 1.47]

5.2 Short‐term outcomes 9‐16 weeks

2

255

Risk Ratio (M‐H, Fixed, 95% CI)

0.40 [0.21, 0.79]

5.3 Intermediate outcomes 17‐24 weeks

1

37

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.17, 2.46]

6 Interventions with postnatal only component ‐ depressive symptomatology Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Immediate outcomes 0‐8 weeks

6

3099

Risk Ratio (M‐H, Random, 95% CI)

0.63 [0.41, 0.98]

6.2 Short‐term outcomes 9‐16 weeks

6

3361

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.53, 1.11]

6.3 Intermediate outcomes 17‐24 weeks

6

10352

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.82, 1.06]

6.4 Long‐term outcomes >24 weeks

3

2663

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.46, 0.93]

7 Interventions with postnatal only component ‐ mean depression scores Show forest plot

8

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

Subtotals only

7.1 Immediate outcomes 0‐8 weeks

2

716

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

‐0.14 [‐0.69, 0.42]

7.2 Short‐term outcomes 9‐16 weeks

5

3205

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

‐0.35 [1.00, 0.31]

7.3 Intermediate outcomes 17‐24 weeks

5

8710

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

0.01 [‐0.03, 0.06]

7.4 Long‐term outcomes > 24 weeks

2

1004

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

‐0.59 [‐1.39, 0.21]

8 Interventions with postnatal only component ‐ diagnosis of depression Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 Short‐term outcomes 9‐16 weeks

1

612

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.34, 1.23]

9 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology: at final study assessment Show forest plot

20

14727

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.66, 0.93]

9.1 Antenatal and postnatal intervention

8

1941

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.75, 1.22]

9.2 Postnatal intervention only

12

12786

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.59, 0.90]

10 TEST FOR SUBGROUP DIFFERENCES: mean depression scores: at final study assessment Show forest plot

19

12376

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

‐0.13 [‐0.28, 0.01]

10.1 Antenatal intervention only

4

1050

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

0.03 [‐0.09, 0.16]

10.2 Antenatal and postnatal intervention

7

1000

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

‐0.14 [‐0.31, 0.02]

10.3 Postnatal intervention only

8

10326

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

‐0.16 [‐0.40, 0.08]

11 TEST FOR SUBGROUP DIFFERENCES: diagnosis of depression: at final study assessment Show forest plot

5

939

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.31, 0.74]

11.1 Antenatal intervention only

1

35

Risk Ratio (M‐H, Fixed, 95% CI)

0.08 [0.00, 1.34]

11.2 Antenatal and postnatal intervention

3

292

Risk Ratio (M‐H, Fixed, 95% CI)

0.44 [0.24, 0.80]

11.3 Postnatal intervention only

1

612

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.34, 1.23]

1 Interventions for at‐risk women ‐ depressive symptomatology Show forest plot

9

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Immediate outcomes 0‐8 weeks

7

1301

Risk Ratio (M‐H, Random, 95% CI)

0.67 [0.51, 0.88]

1.2 Short‐term outcomes 9‐16 weeks

6

1368

Risk Ratio (M‐H, Random, 95% CI)

0.59 [0.47, 0.75]

1.3 Intermediate outcomes 17‐24 weeks

2

151

Risk Ratio (M‐H, Random, 95% CI)

1.34 [0.60, 2.98]

1.4 Long‐term outcomes > 24 weeks

2

281

Risk Ratio (M‐H, Random, 95% CI)

0.60 [0.29, 1.24]

2 Interventions for at‐risk women ‐ mean depression scores Show forest plot

7

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

Subtotals only

2.1 Immediate outcomes 0‐8 weeks

3

387

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

‐0.17 [‐0.52, 0.18]

2.2 Short‐term outcomes 9‐16 weeks

5

1067

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

‐0.14 [‐0.26, ‐0.02]

2.3 Intermediate outcomes 17‐24 weeks

1

30

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

‐0.02 [‐0.74, 0.70]

2.4 Long‐term outcomes >24 weeks

3

324

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

‐0.00 [‐0.22, 0.22]

3 Interventions for at‐risk women ‐ diagnosis of depression Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Immediate outcomes 0‐8 weeks

1

39

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 1.47]

3.2 Short‐term outcomes 9‐16 weeks

4

902

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.30, 0.74]

3.3 Intermediate outcomes 17‐24 weeks

1

37

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.17, 2.46]

3.4 At final study assessment

5

939

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.31, 0.74]

4 Interventions for general population ‐ depressive symptomatology Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Immediate outcomes 0‐8 weeks

7

3767

Risk Ratio (M‐H, Random, 95% CI)

0.69 [0.46, 1.03]

4.2 Short‐term outcomes 9‐16 weeks

4

2614

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.58, 1.42]

4.3 Intermediate outcomes 17‐24 weeks

7

10485

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.81, 1.06]

4.4 Long‐term outcomes > 24 weeks

3

2655

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.51, 0.99]

5 Interventions for general population ‐ mean depression scores Show forest plot

12

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

Subtotals only

5.1 Immediate outcomes 0‐8 weeks

3

847

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

‐0.15 [‐0.56, 0.25]

5.2 Short‐term outcomes 9‐16 weeks

4

2561

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

‐0.40 [‐1.24, 0.44]

5.3 Intermediate outcomes 17‐24 weeks

9

9914

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

0.01 [‐0.03, 0.05]

5.4 Long‐term outcomes > 24 weeks

4

2123

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

‐0.28 [‐0.87, 0.30]

6 TEST FOR SUBGROUP DIFFERENCES: depressive symptomatology: at final study assessment Show forest plot

20

14727

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.66, 0.93]

6.1 Interventions for at‐risk women

8

1853

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.50, 0.88]

6.2 General population

12

12874

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.68, 1.02]

7 TEST FOR SUBGROUP DIFFERENCES: mean depression scores: at final study assessment Show forest plot

19

12376

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

‐0.13 [‐0.28, 0.01]

7.1 Interventions for at risk women

7

1087

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

‐0.13 [‐0.25, ‐0.01]

7.2 General population

12

11289

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

‐0.15 [‐0.33, 0.04]