Effects of a Personalized Stress Management Intervention on Maternal Mental Health: A Randomized Clinical Trial.

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health Pub Date : 2025-09-17 DOI:10.1007/s00737-025-01619-5

S Darius Tandon, Judith T Moskowitz, Renee C Edwards, Yudong Zhang, Gina Giase, Brianna Sinche, Abigail L Blum, S Krislov, Haley M Reynolds, Aditi Rangarajan, Peter Cummings, Amélie Petitclerc, Nabil Alshurafa, William A Grobman, Erin A Ward, Lauren S Wakschlag

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引用次数: 0

Abstract

Purpose: While interventions to mitigate and prevent perinatal maternal distress exist, none are personalized based on participants' daily experiences and intervention response. This study compared maternal distress outcomes (depressive symptoms, anxiety symptoms, perceived stress) between perinatal individuals receiving a personalized mobile health-enhanced cognitive-behavioral intervention and individuals receiving usual prenatal care.

Methods: Pregnant individuals ≤ 22 weeks' gestation recruited from six prenatal care clinics were randomized to the intervention or usual prenatal care. Intervention participants received a 12-session adaptation of the Mothers and Babies intervention (MB-P), personalized by just-in-time stress reduction and mindfulness content based on elevated physiologic or self-reported stress. Primary outcomes were depressive and anxiety symptoms, and perceived stress. Secondary outcomes were behavioral activation, decentering of thoughts, social support, and mood regulation. Outcomes were measured at baseline, one-week post-intervention, one month postpartum, and three months postpartum. An intent-to-treat approach using mixed-effects models guided analysis.

Results: Forty-nine individuals were randomized to MB-P and fifty-one to usual prenatal care. Participants were 70% White, 33.7 years old on average, and 16.2 weeks gestation. At three months postpartum, intervention participants had lower depressive symptomatology (d = 0.43) and less perceived stress (d = 0.46) than controls. Intervention participants exhibited greater behavioral activation three months postpartum (d = 0.41), greater decentering post-intervention (d = 0.37), and greater mood regulation post-intervention (d = 0.56) and three months postpartum (d = 0.55).

Conclusion: MB-P improved maternal depression and anxiety and mechanisms of behavioral activation, decentering, and mood regulation when compared to usual prenatal care. Future research should examine MB-P impact compared to standard MB without just-in-time content.

Trial registration: Clinical Trials.gov, NCT05052281.

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个性化压力管理干预对产妇心理健康的影响：一项随机临床试验。

目的：虽然存在缓解和预防围产期产妇窘迫的干预措施，但没有一项是基于参与者的日常经历和干预反应进行个性化的。本研究比较了围产期接受个性化移动健康增强认知行为干预的个体和接受常规产前护理的个体之间的产妇痛苦结局（抑郁症状、焦虑症状、感知压力）。方法：从6家产前护理诊所招募妊娠≤22周的孕妇，随机分为干预组和常规产前护理组。参与干预的参与者接受了12期母婴干预（MB-P）的调整，根据生理或自我报告的压力升高，通过及时减轻压力和正念内容进行个性化。主要结局是抑郁和焦虑症状，以及感知压力。次要结果是行为激活、思想分散、社会支持和情绪调节。在基线、干预后一周、产后一个月和产后三个月测量结果。使用混合效应模型的意向治疗方法指导了分析。结果：49例患者随机接受MB-P治疗，51例接受常规产前护理。参与者70%为白人，平均年龄33.7岁，妊娠期16.2周。在产后3个月，干预参与者的抑郁症状（d = 0.43）和感知压力（d = 0.46）均低于对照组。干预后参与者表现出更大的行为激活（d = 0.41），干预后更大的去中心化（d = 0.37），干预后（d = 0.56）和产后3个月（d = 0.55）更大的情绪调节。结论：与常规产前护理相比，MB-P改善了产妇的抑郁和焦虑，并改善了行为激活、去中心化和情绪调节机制。未来的研究应该检查MB- p对没有即时内容的标准MB的影响。试验注册：Clinical Trials.gov, NCT05052281。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.