On 2 November 2017, Astrid Kamperman joined the Maternal Health Task Force (MHTF) for a panel discussion about noncommunicable diseases (NCDs) and maternal health. Later, the researcher based at the Erasmus Medical Center in the Netherlands sat down with the MHTF’s Sarah Hodin to talk more about her research on maternal mental health.
SH: Your paper, “Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis,” was published in the MHTF-PLOS Collection on NCDs and maternal health. What was the impetus for that study?
AK: The problem is that there are a substantial number of women around the world who experience mental illness during pregnancy, and we don’t really know how to help them most effectively. My research team and I set out to conduct a systematic review to identify high quality studies that have tested interventions to treat all kinds of mental disorders in pregnant women.
SH: What did you find?
AK: Twenty-eight of the 29 papers we included in the analysis targeted major depressive disorder. I was surprised to see how little research has been done on other types of mental health issues during pregnancy such as bipolar disorder, schizophrenia and anxiety. We didn’t find any clinical trials that evaluated the effects of medication for mental health disorders during pregnancy on women.
The interventions we examined fell into six broad categories: cognitive behavioral therapy, acupuncture, bright light therapy, interpersonal therapy, body-oriented and mindfulness approaches and food supplements. Based on the available evidence, the most effective interventions tended to be psychotherapies: cognitive behavioral therapy and interpersonal therapy. Limited evidence on body-oriented and mindfulness approaches also showed positive effects. However, we need more research on these interventions and their effects on different mental disorders before drawing conclusions on effectiveness.
SH: During the panel discussion earlier, you talked about stigma associated with mental health disorders during pregnancy. Can you talk more about that?
AK: As I mentioned, I think we are still living in the myth of the “happy pregnancy.” We need to get rid of the stigma, especially since one in ten women globally experience a major mental health disorder during pregnancy. Women, their babies and their families are not helped in any way by stereotypes about pregnancy being a wonderful, struggle-free period. The current stigma around mental illness prevents women from feeling safe enough to express their mental health concerns and also prevents health care providers from asking the right questions.
SH: What else would you like MHTF readers to know about mental health during pregnancy?
AK: Many women use some type of medication for symptoms of mental illness. During pregnancy, it is important to consider the potential benefits and harms for both mother and baby when making recommendations about medication. Unfortunately, we still have many unanswered questions in this area because of limited research. It is time to start taking the burden and consequences of mental illness in pregnancy more seriously.
Learn more about perinatal mental health.
Watch the video from the panel discussion featuring Astrid Kamperman about NCDs and maternal health.
Explore other open access papers from the MHTF-PLOS Collection on NCDs and maternal health