دانلود رایگان مقاله انگلیسی اقدامات بهداشتی مکمل برای درمان افسردگی پرناتال - الزویر 2018

INTRODUCTION

Approximately 14% to 23% of women develop depression during pregnancy and up to 16.7% develop depression within 3 months postdelivery.1 Perinatal depression (PND) is underdiagnosed and few women receive treatment.2 Untreated PND is associated with functional impairment and adverse health outcomes for mother and child, including obstetric and neonatal complications3 and a broad negative impact on child development.4 Maternal suicide is the leading cause of maternal death occurring within 1 year postpartum.5 Fortunately, safe and effective treatment options exist, including psychotherapy6 and antidepressants.7 However, an understanding of complementary health practices (CHPs) is important, because perinatal women may inquire about nonpharmacologic treatments. CHPs include a diverse range of practices that are developed outside of mainstream Western medicine. Most CHPs fall into two categories: natural products or mind and body practices. Natural products, including herbs, vitamins, minerals, and probiotics, are the most widely used CHP in the United States. Mind and body practices include techniques that are typically administered or taught by a practitioner. Physical activity interventions may also be conceptualized as a form of CHP.

SUMMARY

Given high levels of interest in CHPs during the perinatal period, there is a need for research addressing acceptability, safety, and efficacy of these interventions. Large-scale surveys suggest many perinatal women already seek out CHP for potential health benefits, even in the absence of clear safety and efficacy data, and a substantial subset of perinatal women report that their prenatal care providers do not ask about their use of CHPs.89 As such, it is important for providers to routinely inquire about patients’ interest in and use of CHPs, and additional research is needed to provide clear data to guide decisions about which products and practices are helpful and safe. With a vast array of CHPs, we did not attempt to review evidence for all products or interventions. We examined data regarding some of the most commonly used CHPs, including various natural products and vitamins and popular mind and body approaches. Until subsequent research is conducted and questions answered, our review has found encouraging preliminary evidence supporting efficacy of O-3FA, folate, vitamin D (in cases of deficiency), physical activity interventions, and prenatal/postpartum yoga for reducing or preventing PND symptoms. However, some approaches have only been examined during pregnancy, and others only in the postpartum.