Early Prenatal Mental Health Interventions Reduce Postpartum Risks

Prenatal mental health interventions reduced the risk of moderate-to-severe postpartum anxiety by two-thirds in an NIH-funded study based in the Punjab Province of Pakistan. According to an NIH press release, the study ran from April 2019 to January 2022 and was led by a researcher at the Johns Hopkins Bloomberg School of Public Health.

Pregnant women in Pakistan who experienced at least mild anxiety without clinical depression were assigned to receive routine pregnancy care or cognitive behavioral therapy (CBT) with a professional who hadn’t had clinical experience before the start of this study.

The CBT-based intervention was called Happy Mother–Healthy Baby (HMHB), which used similar strategies as the Thinking Health Program, a psychosocial intervention studied in women experiencing perinatal depression. Strategies included developing empathetic relationships, thought challenging, behavior activation, problem management, and enhanced family involvement and support.

Women in the HMHB group were advised and guided through the following:

• Thought and behavior identification
• Unhealthy thought and behavior replacement
• Healthy thinking and behavior practices

Patients in the experimental group had six core treatment sessions and six supplementary, optional booster sessions. The first five of the core sessions and all of the supplementary sessions were conducted during early- to mid-pregnancy, while the final core session was conducted in the final trimester.

To understand the impacts of prenatal interventions on postpartum depression and anxiety, the researchers conducted anxiety and depression assessments on all participants at six weeks postpartum.

While 27% of 375 women who received routine childcare had postpartum anxiety, only 9% of the 380 women in the HMHB group were diagnosed with postpartum anxiety. Additionally, approximately 41% of women in the control group experienced postpartum depression, while only 12% of those in the intervention group did.

“In the future, we can build on these findings through implementation research. 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,” said Pamela J. Surkan, PhD, ScD, lead investigator, in the press release.