| Zheng Shuang,Yang Luping,Huang Binyang,Cao Miao,Li Mengxiao,Yang Wenjun,Guo Chunliang,Zheng Rongmei,Zhang Yuyang,Li Hua,Efficacy and safety of repetitive transcranial magnetic stimulation in the treatment of postpartum depression： a Meta-analysis[J].SICHUAN MENTAL HEALTH,2025,(6):568-576 |
| Efficacy and safety of repetitive transcranial magnetic stimulation in the treatment of postpartum depression： a Meta-analysis |
DOI：10.11886/scjsws20250305007 |
| English keywords:Repetitive transcranial magnetic stimulation Postpartum depression Meta-analysis |
| Fund projects:四川省心理学会科研规划项目（项目名称：主观幸福感与产后抑郁的关系：领悟社会支持的中介作用，项目编号：SCSXLXH202403099）；广元市指导性科技计划项目（项目名称：“互联网+”背景下延伸护理在产后妇女抑郁中的应用模式研究，项目编号：23ZDYF0095） |
| Author Name | Affiliation | Postcode | | Zheng Shuang | Sichuan Nursing Vocational College, Chengdu 610100, China | 610100 | | Yang Luping | Sichuan Nursing Vocational College, Chengdu 610100, China | 610100 | | Huang Binyang | Sichuan Nursing Vocational College, Chengdu 610100, China | 610100 | | Cao Miao | Sichuan Nursing Vocational College, Chengdu 610100, China | 610100 | | Li Mengxiao | Sichuan Nursing Vocational College, Chengdu 610100, China | 610100 | | Yang Wenjun | Sichuan Mental Health Center·The Third Hospital of Mianyang, Mianyang 621000, China | 621000 | | Guo Chunliang | Jiangyou People's Hospital, Mianyang 611137, China | 611137 | | Zheng Rongmei | Guangyuan Mental Health Center, Guangyuan 628000, China | 628000 | | Zhang Yuyang | Sichuan Nursing Vocational College, Chengdu 610100, China | 610100 | | Li Hua* | Jiangyou People's Hospital, Mianyang 611137, China | 611137 |
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| Background Postpartum depression （PPD） is a prevalent postpartum complications that significantly compromises women's psychological and physical well-being. Repetitive transcranial magnetic stimulation （rTMS）， a conventional neuromodulation technique， has been increasingly used in the treatment of PPD. However， high-quality evidence regarding its efficacy and safety remains limited.Objective To evaluate the efficacy and safety of rTMS in the treatment of PPD， thereby providing references for clinical treatment.Methods Databases including Cochrane Library， PubMed， Embase， CNKI， Wanfang， VIP and China Biology Medicine disc （CBM） were electronically searched for randomized controlled trials （RCTs） on rTMS for PPD， with the search spanning from database inception to February 8， 2025. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1， and the certainty of evidence was graded according to the Grading of Recommendations Assessment， Development and Evaluation （GRADE） approach. Meta-analysis was conducted using RevMan 5.3 and Stata 12.0. The outcomes of the Meta-analysis included the total effective rate， Edinburgh Postnatal Depression Scale （EPDS） score， Hamilton Depression Rating Scale （HAMD） score， and adverse reactions （dizziness， headache， nausea， diarrhea， and the overall incidence of adverse reactions）.Results A total of 11 studies involving 729 patients with PPD were included. Meta-analysis results showed that the total effective rate in the study group was significantly higher than that in the control group （OR=5.54， 95% CI： 3.07–10.01， P<0.01）. Both EPDS score （SMD=-2.38， 95% CI： -3.39–-1.37， P<0.01） and HAMD score （SMD=2.53， 95% CI： 1.21–3.85， P<0.01） in the study group were significantly lower than those in the control group， with statistically significant differences. Comparisons between the study group and control group reveal no significant differences in the incidence of dizziness and headache （RR=1.47， 95% CI： 0.63–3.43， P>0.05）， nausea （RR=1.46， 95% CI： 0.55–3.86， P>0.05）， diarrhea （RR=0.71， 95% CI： 0.23–2.20， P>0.05）， and overall adverse reactions （RR=1.30， 95% CI： 0.79–2.15， P>0.05）. GRADE assessment rated the four indicators of dizziness and headache， diarrhea， overall incidence of adverse reactions， and EPDS score as "moderate-certainty evidence"， and rated the total effective rate， nausea， and the HAMD score as "low-certainty evidence".Conclusion rTMS demonstrates certain therapeutic efficacy for PPD， with a safety profile comparable to conventional treatment. ［Funded by Sichuan Psychological Society Research Planning Project （number， SCSXLXH202403099）； Guiding Science and Technology Plan Project of Guangyuan （number， 23ZDYF0095）］ |
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