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
{"title":"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。","authors":"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","doi":"10.1007/s00737-025-01619-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong> Clinical Trials.gov, NCT05052281.</p>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of a Personalized Stress Management Intervention on Maternal Mental Health: A Randomized Clinical Trial.\",\"authors\":\"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\",\"doi\":\"10.1007/s00737-025-01619-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong> Clinical Trials.gov, NCT05052281.</p>\",\"PeriodicalId\":8369,\"journal\":{\"name\":\"Archives of Women's Mental Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Women's Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00737-025-01619-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Women's Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00737-025-01619-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Effects of a Personalized Stress Management Intervention on Maternal Mental Health: A Randomized Clinical Trial.
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.
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.
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