We sought to establish the feasibility and preliminary effects of home-wearable light therapy for postpartum depression, and its effects on circadian measures. Eight women within 6 months postpartum were prescribed 60 min of daily morning light therapy for 5 weeks. The device was well tolerated. Significant improvements were observed in self-report and clinician-rated depression symptoms, with little change in objective circadian measures. Home-wearable light therapy is feasible for postpartum women and may be a promising treatment for postpartum depression. Clinicaltrials.gov Identifier: NCT02769858.

BACKGROUND:There is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent.

AIM:To assess the effectiveness of aerobic exercise on postpartum depressive symptoms.

DESIGN AND SETTING:Systematic review and meta-analysis. There was no restriction to study site or setting.

METHOD:The databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, Clinical Trials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched. Titles and abstracts, then full-text articles, were screened against inclusion criteria: RCTs measuring depressive symptoms in mothers≤1 year postpartum; and interventions designed to increase aerobic exercise compared with usual care or other comparators. Included studies were assessed using the Cochrane Collaboration's risk of bias tool. Meta-analysis was conducted. Pre-planned subgroup analyses explored heterogeneity.

RESULTS:Thirteen RCTs were included, with 1734 eligible participants. Exercise significantly reduced depressive symptoms when all trials were combined (standardised mean difference -0.44; 95% confidence interval = -0.75 to -0.12). Exploration of heterogeneity did not find significant differences in effect size between women with possible depression and in general postpartum populations; exercise only and exercise with co-interventions; and group exercise and exercise counselling.

CONCLUSION:This systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias.

BACKGROUND:In this preliminary study, we examined the effect of acupressure, acupuncture and moxibustion (oriental treatments) to prevent of the relapse/deterioration of perinatal depression in women with pregnancy-related anxiety and previous depression.

METHODS AND RESULTS:Between 2014 and 2016, there were 48 women with pregnancy-related anxiety and previous depression who had delivery at≥ 22 weeks' gestation in our institute. Of these, oriental treatments were performed in eight and two women (totally 10, 21%) during pregnancy and postpartum, respectively. One of the 10 (10%) who received oriental treatments admitted depressive symptoms during pregnancy or postpartum, while 18 ofthe rest 38 who did not receive oriental treatments admitted depressive symptoms (47%, P = 0.065).

CONCLUSION:The oriental treatments may be useful for pregnant women who need perinatal mental health care.

In 2001 it was discovered that exposing the eyes to light in the blue end of the visible spectrum suppresses the production of the sleep hormone, melatonin. New mothers need to get up during the night to care for their babies. This is the time when melatonin is normally flowing. Exposing their eyes to light can cut off the flow. It may also reset their circadian (internal) clock. On subsequent nights the melatonin may not begin flowing at the normal time making it difficult to fall asleep. Over time, disruption of the circadian rhythm plus sleep deprivation may result in depression. Women suffering postpartum depression were enrolled in a small clinical trial. Some were provided with glasses and light bulbs that block blue light. Others were equipped with glasses and light bulbs that looked colored but did not block the rays causing melatonin suppression. Those with the"real glasses"recovered somewhat more quickly than those with the placebo glasses and light bulbs. The hypothesis that should be tested in large scale clinical trials is that the risk of postpartum depression can be reduced when a new mother avoids exposing her eyes to blue light when she gets up at night to care for her baby. In the meantime, all new mothers may benefit from using glasses and light bulbs that block blue light when getting up at night to care for their babies.