Counseling Recommended by USPSTF to Combat Perinatal Depression

The U.S. Preventive Services Task Force (USPSTF) has put forth a new recommendation advocating for counseling services aimed at women identified as being at higher risk for perinatal depression (PND). This proposal was detailed in a draft recommendation statement released online on April 22, 2025.

In an effort to update its 2019 guidelines, researchers from the USPSTF conducted a comprehensive review of existing literature on the effectiveness of various primary care interventions designed to prevent PND. Their investigation included data from 75 clinical trials, encompassing a total of 30,842 participants. A significant number of these trials focused on women deemed at increased risk for developing PND. This was evident as the control groups exhibited higher event rates than what is currently estimated for PND in the U.S.

Among the interventions investigated, counseling emerged as the most frequently studied option, demonstrating consistent and positive outcomes in both the incidence of depression and the severity of depressive symptoms. Specifically, 27 trials involving 6,583 participants assessed behavioral counseling methods, predominantly employing cognitive behavioral therapy and interpersonal therapy techniques. The results indicated that these counseling interventions led to a 17% reduction in the risk of depression at the longest follow-up period.

Furthermore, educational interventions were evaluated in 12 trials involving 11,415 participants, which revealed a 21% decrease in the incidence of depression. However, these educational approaches did not result in statistically significant changes in the standardized mean difference regarding the change in depressive symptoms.

Based on these findings, the USPSTF has issued a recommendation encouraging healthcare providers to offer or refer individuals at heightened risk for PND to counseling interventions during both pregnancy and the postpartum period. This recommendation is classified as a 'B' recommendation, indicating that there is moderate certainty that the benefits of the service outweigh the risks.

The draft recommendation statement, along with the accompanying evidence review, has been made available for public comment. Stakeholders and the general public are invited to submit their feedback from April 22 through May 19, 2025.

For more detailed information, the draft evidence review and recommendation statement can be accessed through the USPSTF's official communication channels.