International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 182-189 http://medscipublisher.com/index.php/ijccr 185 4 Meta-Analysis Results on the Effects of Rooming-In Care on Postpartum Depression 4.1 Include the research overview and quality assessment results Meta-analyses on the relationship between rooming-in with infants and postpartum depression typically include longitudinal studies and intervention studies, with sample sizes ranging from dozens to hundreds. Most of these studies used standard tools such as the Edinburgh Postnatal Depression Scale (EPDS) and conducted follow-up evaluations around two months postpartum (Table 1) (Lichter et al., 2020). The quality assessment of research mainly depends on the research design, the way participants are selected, and whether standard assessment methods are adopted. Most studies have reached a medium or high level in terms of methods. Table 1 PPD prevalence at 2 months after birth according to rooming-in group (Adopted from Lichter et al., 2020) Total Full rooming-in Partial rooming-in (N=312) (N=142) (N=170) n(%) n(%) n(%) EPDS score ≥10 14(4.5) 2(1.4) 12(7.2) EPDS score <10 298(95.5) 140(98.6) 158(92.8) EPDS score ≥13 10(3.2) 2(1.4) 8(4.8) EPDS score <13 302(96.8) 140(98.6) 162(95.2) Table caption: EPDS, Edinburgh Postnatal Depression Scale The literature also points out that when evaluating the effect of rooming-in with infants, individual risk factors should be considered, such as unstable emotional attachment (Lichter et al., 2020). Some studies specifically focus on rooming-in with infants, while others involve similar intervention methods, such as skin-to-skin contact care. These methods are similar in principle, but may differ in implementation methods and intensities (Scime et al., 2019). Overall, the use of long-term follow-up and standard depression assessment tools has enhanced the credibility of the research, but the differences in intervention details remain a challenge. 4.2 Aggregated effects of key indicators Meta-analysis shows that when fully implementing rooming-in for infants, it may help alleviate the association between emotional attachment insecurity and postpartum depression, and reduce the risk of depressive symptoms in some high-risk populations. However, overall, the pooled results did not find that room-sharing with infants could significantly reduce the incidence of overall postpartum depression or EPDS score (Lichter et al., 2020; Zhou et al., 2020). This protective effect is more prominently manifested in those mothers who were originally at higher risk, such as individuals with emotional attachment anxiety. Similar interventions such as skin-to-skin contact care had a slight but statistically significant decrease in depression scores compared with conventional care (a decrease of 1.04%, P<0.001), but the clinical significance of this effect was still relatively limited (Scime et al., 2019). These results suggest that rooming-in with infants and similar methods may be helpful for some high-risk groups, but their overall impact on postpartum depression remains minimal. 4.3 Heterogeneity analysis, sensitivity testing and assessment of publication bias There are significant differences among different studies. The duration of intervention, the intensity of implementation, the characteristics of participants, and the evaluation methods vary, resulting in obvious differences in the outcomes (Scime et al., 2019). For example, whether rooming-in with infants is fully implemented and whether there is other psychological support will affect its effect (Lichter et al., 2020). Sensitivity analysis shows that studies with high-quality methods or higher risks in the research subjects are more likely to observe significant effects. Regarding the detection of publication bias, such as funnel plot asymmetry and Egger's test, most results did not detect significant bias (Scime et al., 2019; Huang et al., 2024). However, as the number of studies is not large and some small-sample studies have a significant impact on the results, these data need to be interpreted with caution.
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