Counselling to prevent perinatal depression

Talk-based support, such as cognitive behavioral therapy or interpersonal therapy, offered to pregnant and postpartum people who are at higher risk of developing depression, with the aim of preventing it. In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer people at increased risk to this kind of counselling.

Intervention
In this atlas

Overview

Technical summary

USPSTF 2019 (B recommendation): provide or refer pregnant and postpartum persons at increased risk to counselling interventions; convincing evidence that cognitive behavioral and interpersonal therapy are effective in preventing perinatal depression; harms bounded as no greater than small; moderate certainty of moderate net benefit; inadequate evidence for non-counselling interventions (see the claim on this page). One randomised trial of a group intervention based on interpersonal therapy in 205 pregnant women on public assistance found depression rates of 16% against 31% at 6 months (see the second claim). NIMH separately names cognitive behavioral and interpersonal therapy as evidence-based therapies for treating perinatal depression; this page is about prevention. The USPSTF guideline record is linked through the claim; it links to the shared USPSTF record in core. The recipient is the pregnant or postpartum person.

About this intervention

Type: Service
Mechanism: Not reported

Claims and evidence

Context Pregnant and postpartum persons at increased risk of perinatal depression (USPSTF, 2019)

Recipient: Maternal
Population: Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.
Care setting: Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.
Geography: United States (USPSTF recommendation statement)
Life stage: Pregnancy and postpartum
Gestational age: Not reported
Postnatal age: Not reported
Follow-up: Not applicable (recommendation context)

Eligibility: 2 inclusion criteria; 1 exclusion criterion

Included: Pregnant or postpartum
At increased risk of perinatal depression
Excluded: People not at increased risk: the USPSTF statement addresses those at increased risk

Recommendation Guidance Certainty not assessed

In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counselling interventions (B recommendation). It found convincing evidence that counselling such as cognitive behavioral therapy and interpersonal therapy is effective in preventing perinatal depression, bounded the potential harms of counselling as no greater than small, and concluded with moderate certainty that referral of people at increased risk has a moderate net benefit. It found inadequate evidence on the benefits and harms of other, non-counselling interventions.
Applies to Maternal
- Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.
- Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.
- United States (USPSTF recommendation statement)
- Pregnancy and postpartum
- Gestational age Not reported
- Postnatal age Not reported
Follow-up Not applicable (recommendation context)
Certainty method
Not assessed

Limitations
Only the PubMed abstract of the JAMA statement was read, not the full statement or its evidence review. The USPSTF letter grade and its certainty wording are the Task Force's own and are not a GRADE rating, so the certainty field is left not assessed. The recommendation is about preventing depression in people at increased risk; it is not a recommendation about treatment, and it is not advice for any individual. The abstract names no programme or number of sessions.

Last checked
2026-10-14

Next evidence check due
Not scheduled
Sources and citations (10)
1. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, CONCLUSIONS AND RECOMMENDATION, sentence 1
  
  How it applies
  The recommendation.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
2. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, CONCLUSIONS AND RECOMMENDATION, sentence 2
  
  How it applies
  The grade.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
3. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 1
  
  How it applies
  Evidence on counselling.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
4. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 2, fragment 1 of 2
  
  How it applies
  Who could be considered at increased risk, part 1.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
5. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 2, fragment 2 of 2
  
  How it applies
  Who could be considered at increased risk, part 2.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
6. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 3, fragment 1 of 2
  
  How it applies
  Harms bounded as no greater than small, part 1.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
7. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 3, fragment 2 of 2
  
  How it applies
  Harms bounded as no greater than small, part 2.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
8. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 5, fragment 1 of 2
  
  How it applies
  Certainty and net benefit, part 1.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
9. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 5, fragment 2 of 2
  
  How it applies
  Certainty and net benefit, part 2.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
10. Supports Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement
  
  Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2019-02-12 · DOI: 10.1001/jama.2019.0007 · PMID: 30747971
  
  Locator
  Abstract, FINDINGS, sentence 4
  
  How it applies
  Other interventions: inadequate evidence.
  
  Retrieved
  2026-10-14T18:18:31Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Context Pregnant women aged 18 or older on public assistance and at risk of postpartum depression

Recipient: Maternal
Population: 205 pregnant women aged 18 years or older, on public assistance and at risk for postpartum depression (mean age 23; 38% Hispanic and 23% Black), randomized to a group intervention based on interpersonal therapy (n=104) or a treatment-as-usual programme (n=101).
Care setting: Not stated in the abstract.
Geography: Not stated in the abstract.
Life stage: Pregnancy, with the depression rate assessed 6 months postpartum
Gestational age: Not reported
Postnatal age: Not reported
Follow-up: Depression rate at 6 months (abstract).

Eligibility: 4 inclusion criteria; 1 exclusion criterion

Included: Pregnant
Aged 18 years or older
On public assistance
At risk for postpartum depression
Excluded: Not stated in the abstract

Effect Interventional Certainty not assessed

In a randomized controlled trial of 205 pregnant women aged 18 or older who were on public assistance and at risk for postpartum depression, a group intervention based on the principles of interpersonal therapy (n=104) was compared with a treatment-as-usual programme (n=101). At 6 months the overall depression rate was 16% in the intervention group and 31% in the control group, a difference the authors report as statistically significant at p<0.05.
Applies to Maternal
- 205 pregnant women aged 18 years or older, on public assistance and at risk for postpartum depression (mean age 23; 38% Hispanic and 23% Black), randomized to a group intervention based on interpersonal therapy (n=104) or a treatment-as-usual programme (n=101).
- Not stated in the abstract.
- Not stated in the abstract.
- Pregnancy, with the depression rate assessed 6 months postpartum
- Gestational age Not reported
- Postnatal age Not reported
Follow-up Depression rate at 6 months (abstract).
Certainty method
Not assessed

Limitations
Only the PubMed abstract was read. The authors note it is unknown whether the findings generalize to a more heterogeneous sample of women, such as women from a range of socio-economic and cultural backgrounds, or marital status, and that the amount of contact differed between the treatment-as-usual and intervention conditions. The abstract names no country or setting and gives no confidence interval. This is one trial of one programme and not a statement about counselling in general.

Last checked
2026-10-14

Next evidence check due
Not scheduled
Sources and citations (8)
1. Supports Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, METHODS, sentence 1
  
  How it applies
  Trial design and participants.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
2. Supports Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, METHODS, sentence 2, fragment 1 of 2
  
  How it applies
  Participant details and group sizes, part 1.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
3. Supports Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, METHODS, sentence 2, fragment 2 of 2
  
  How it applies
  Group sizes, part 2.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
4. Supports Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, RESULTS, sentence 1, fragment 1 of 2
  
  How it applies
  Depression rates at 6 months.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
5. Supports Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, RESULTS, sentence 1, fragment 2 of 2
  
  How it applies
  Statistical significance.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
6. Background Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, LIMITATIONS, sentence 1, fragment 1 of 2
  
  How it applies
  Authors' generalisability limit.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
7. Background Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, LIMITATIONS, sentence 1, fragment 2 of 2
  
  How it applies
  Authors' generalisability limit, continued.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
8. Background Randomized controlled trial to prevent postpartum depression in mothers on public assistance
  
  Publication · Journal of affective disorders · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-01-01 · DOI: 10.1016/j.jad.2015.09.059 · PMID: 26454186 · PMCID: PMC4641029
  
  Locator
  Abstract, LIMITATIONS, sentence 2
  
  How it applies
  Authors' note on contact.
  
  Retrieved
  2026-10-14T18:18:21Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7
  
  Reuse basis
  PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Guidance

Recommended: Counselling to prevent perinatal depression

Applies to Maternal

Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.
Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.
United States (USPSTF recommendation statement)
Pregnancy and postpartum
Gestational age Not reported
Postnatal age Not reported

Follow-up Not applicable (recommendation context)

Issued by: U.S. Preventive Services Task Force
Guideline: USPSTF 2019: interventions to prevent perinatal depression; Perinatal Depression: Preventive Interventions (USPSTF final recommendation statement page), edition Final recommendation statement page as fetched on 2026-10-14 (mx-uspstf-perinatal-depression-preventive-interventions.html). The date under the title is February 12, 2019.
Strength: B recommendation (USPSTF letter grades: A, B, C and D recommendations, and the I statement for when the evidence is insufficient to recommend for or against. The grade reflects the Task Force's certainty about net benefit. These are not GRADE strength labels.)
Effective: 2019-02-12 (The date under the title of the USPSTF final recommendation statement page, February 12, 2019. The statement was also published in JAMA, which has its own issue date.)
Jurisdictions: United States; note: United States (the issuer is a United States task force).
Supersession: Not checked

Basis: In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counselling interventions (B recommendation). It found convincing evidence that counselling such as cognitive behavioral therapy and interpersonal therapy is effective in preventing perinatal depression, bounded the potential harms of counselling as no greater than small, and concluded with moderate certainty that referral of people at increased risk has a moderate net benefit. It found inadequate evidence on the benefits and harms of other, non-counselling interventions.
Limitations. Only the PubMed abstract of the JAMA statement was read, not the full statement or its evidence review. The USPSTF letter grade and its certainty wording are the Task Force's own and are not a GRADE rating, so the certainty field is left not assessed. The recommendation is about preventing depression in people at increased risk; it is not a recommendation about treatment, and it is not advice for any individual. The abstract names no programme or number of sessions.

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Claim, not a settled fact USPSTF 2019: provide or refer people at increased risk to counselling (B): Perinatal depression (mother) (Recommended for)
Applies to Maternal
- Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.
- Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.
- United States (USPSTF recommendation statement)
- Pregnancy and postpartum
- Gestational age Not reported
- Postnatal age Not reported
Follow-up Not applicable (recommendation context)
In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counselling interventions (B recommendation). It found convincing evidence that counselling such as cognitive behavioral therapy and interpersonal therapy is effective in preventing perinatal depression, bounded the potential harms of counselling as no greater than small, and concluded with moderate certainty that referral of people at increased risk has a moderate net benefit. It found inadequate evidence on the benefits and harms of other, non-counselling interventions.
Limitations. Only the PubMed abstract of the JAMA statement was read, not the full statement or its evidence review. The USPSTF letter grade and its certainty wording are the Task Force's own and are not a GRADE rating, so the certainty field is left not assessed. The recommendation is about preventing depression in people at increased risk; it is not a recommendation about treatment, and it is not advice for any individual. The abstract names no programme or number of sessions.
Claim, not a settled fact Trial of a group interpersonal-therapy based intervention: depression 16% against 31% at 6 months: Perinatal depression (mother) (Evaluated for)
Applies to Maternal
- 205 pregnant women aged 18 years or older, on public assistance and at risk for postpartum depression (mean age 23; 38% Hispanic and 23% Black), randomized to a group intervention based on interpersonal therapy (n=104) or a treatment-as-usual programme (n=101).
- Not stated in the abstract.
- Not stated in the abstract.
- Pregnancy, with the depression rate assessed 6 months postpartum
- Gestational age Not reported
- Postnatal age Not reported
Follow-up Depression rate at 6 months (abstract).
In a randomized controlled trial of 205 pregnant women aged 18 or older who were on public assistance and at risk for postpartum depression, a group intervention based on the principles of interpersonal therapy (n=104) was compared with a treatment-as-usual programme (n=101). At 6 months the overall depression rate was 16% in the intervention group and 31% in the control group, a difference the authors report as statistically significant at p<0.05.
Limitations. Only the PubMed abstract was read. The authors note it is unknown whether the findings generalize to a more heterogeneous sample of women, such as women from a range of socio-economic and cultural backgrounds, or marital status, and that the amount of contact differed between the treatment-as-usual and intervention conditions. The abstract names no country or setting and gives no confidence interval. This is one trial of one programme and not a statement about counselling in general.

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Record id: maternal:perinatal-depression-prevention-counselling
Content hash: 2dd88782d10451597d1b9be40f49f57d52a48eb53d2a1ba0d2b5bc8f2f898dff