Evaluating the Effectiveness of Complementary
and Integrative Health Therapies in Preventing
Postpartum Depression: A Target Trial Emulation Study

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   AMIA Annu Symp Proc 2025 (May 22): 2024: 1557-1566 ~ FULL TEXT

Huixue Zhou, PhD • Yiye Zhang, PhD • Zhenxing Xu, PhD • Chang Su, PhD • Kelvin Lim, MD • Andrea Johnson, MD • Nili Solomonov, PhD • Fei Wang, PhD • Rui Zhang, PhD, FAMIA, FACMI

Institute for Health Informatics,
University of Minnesota,
Minneapolis, MN, USA.

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Subject:   This study aims to evaluate the effectiveness of Complementary and Integrative Health (CIH) therapies in reducing the incidence and severity of Postpartum Depression (PPD) using real-world data and target trial emulation.

Methods:   Using electronic health records (EHR) from a large healthcare system, we emulated target trials for CIH approaches including acupuncture, chiropractic, aromatherapy, and omega-3 fatty acids. CIH usage was identified and extracted from clinical notes using natural language processing (NLP) techniques. Logistic regression-based propensity score matching was employed to address confounding factors. The primary outcome was the incidence of PPD within 12 months postpartum, defined by diagnostic codes or antidepressant initiation. Secondary outcomes included changes in PHQ-9 scores and subgroup analyses by treatment type.

Results:   For the primary outcome, none of the treatments significantly reduced PPD risk intervals (CIs). However, omega-3 fatty acids (combined with) chiropractic care significantly reduced PHQ-9 scores in the treatment groups (omega-3 fatty acids: p<0.001, chiropractic care: p = 0.021), with no comparable improvements in controls.

Aromatherapy showed mixed results, with reduced severe depression in the treatment group but increased severity in controls.

Acupuncture had no significant effect (p > 0.05).

These findings suggest that omega-3 fatty acids and chiropractic care may alleviate PPD symptoms, while the effects of aromatherapy, acupuncture and chiropractic remain inconclusive and warrant further investigation.

Conclusion:   This study provides approach to evaluating CIH interventions in real-world settings. These findings underscore the importance of integrating non-traditional treatment options into clinical practice to improve outcomes for individuals affected by PPD.

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A Probability Primer Based on the provided search results, the text What does this mean: “omega-3: p<0.001; chiropractic: p=0.021” means that a study found both omega-3 supplementation and chiropractic care were statistically significant in improving PHQ-9 scores (a measure of depression symptoms. Here is a breakdown of what these findings mean: p<0.001 (Omega-3): This indicates an extremely strong, statistically significant result. There is less than a 0.1% probability that the improvement in symptoms was due to chance. p=0.021 (Chiropractic): This indicates a statistically significant result since there is roughly a 2%> probability that the result was due to chance.

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