Results from a large clinical trial, published in Nature Medicine, showed that an intervention for anxiety provided to pregnant women significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression, or both 6 weeks after birth.
The unique intervention was administered by non-specialised providers who had the equivalent
of a bachelor’s degree in psychology, but no clinical experience. The results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings.
“In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists,” said Joshua A. Gordon, MD, National Institute of Mental Health, part of the National Institutes of Health, Bethesda, Maryland. “This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period.”
Led by Pamela J. Surkan, PhD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022. Pregnant women with symptoms of at least mild anxiety were randomised to receive either routine pregnancy care or a cognitive behavioural therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The researchers assessed the participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression 6 weeks after the birth of their child.
The researchers found that 9% of women in the intervention group developed moderate-to-severe anxiety compared with 27% of women in the routine care group, and 12% percent of women in the intervention group developed depression compared with 41% of women in the routine care group.
“Postpartum depression not only harms mothers, it is also associated with poorer physical growth and delayed cognitive development in their children,” said Dr. Surkan. “The link between maternal and child health highlights the critical importance of developing effective ways to address postpartum anxiety and depression.”
Women who received the Happy Mother-Healthy Baby intervention took part in 6 intervention sessions where they learned to identify anxious thoughts and behaviours, such as thoughts about possible miscarriage, and to practise replacing them with helpful thoughts and behaviours. The first 5 sessions were conducted in early to mid-pregnancy, and the sixth session occurred in the third trimester.
“In the future, we can build on these findings through implementation research,” said Dr. Surkan. “Having identified an intervention that works, the next step is to figure out the best ways to deliver effective treatment to the people who need it, bridging the gap between science and practice.”
Reference: https://www.nature.com/articles/s41591-024-02809-x
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