Outcomes Reviewed

Depression scores were reported using the EPDS²⁰ and the Beck Depression Inventory, either the original version (BDI) or second version (BDI-II).^32,33 Where studies reported both, we used the EPDS in analysis. To estimate the overall treatment effect, we calculated the standardized mean difference (SMD) for each study with 95% confidence intervals (CIs). The same method was applied to other continuous outcomes, including measures of stress and anxiety. For dichotomous outcomes, such as the number of women who fell below the diagnostic threshold for depression postintervention, we calculated odds ratios. A fixed effect model was used for all analyses. A random effects model was used for further verification of the findings, but results were similar and are therefore not reported. To assess heterogeneity, we calculated the I² statistic for each outcome; a value of 25% indicates a lower degree of heterogeneity, 50% a moderate degree, and 75% a high degree.³⁴ We carried out a sensitivity analysis to test the robustness of the findings by comparing the overall effect sizes after excluding studies with a quality score of less than 30.