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Feasibility study and pilot randomised trial of an antenatal depression treatment with infant follow-up

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Abstract

Substantial evidence links antenatal depression, anxiety and stress with negative effects on foetal development, resulting in enduring problems in child development. Despite this, there is a paucity of research on intervention programmes designed to address depression and anxiety, and none that include infant outcomes. We aimed to evaluate the efficacy of a brief treatment for maternal depression and anxiety in pregnancy in a sample of women with a diagnosed depressive disorder. We developed a cognitive behavioural therapy treatment for antenatal depression and anxiety and evaluated it in a feasibility trial. This was followed by a pilot randomised controlled trial (RCT) which collected data on the efficacy of the brief intervention and follow-up data on infants. The feasibility study (n = 25) yielded promising results for adherence, acceptability and improvements in depression and anxiety (Beck Depression Inventory and Beck Anxiety Inventory). The RCT (n = 54) again showed excellent adherence and acceptability and supported the efficacy of the treatment. Strong reductions in anxiety were observed during pregnancy, and improvements in depression were maintained at 9 months representing a moderately large effect size. Nine-month infant outcomes showed several medium to large effects favouring the intervention in domains including problem solving, self-regulation and stress reactivity, which were independent of maternal postnatal mood. Treating severe depression and anxiety during pregnancy with a brief cognitive behavioural therapy (CBT) intervention appears feasible and worthwhile. To reliably detect clinically meaningful effects on infant outcomes, larger RCTs are likely to be required.

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Acknowledgments

The feasibility study was funded by Australian Rotary Health. The RCT was funded by the MBF/BUPA foundations, Australian Rotary Health, Urquhart Charitable Fund and Austin Medical Research Foundation. We thank the participating women and staff at the hospitals involved.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Parent-Infant Research Institute, Austin Health, 300 Waterdale Road, Heidelberg West, VIC, 3081, Australia

    Jeannette Milgrom, Charlene Holt, Christopher J. Holt, Jessica Ross, Jennifer Ericksen & Alan W. Gemmill

  2. Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, 3010, Australia

    Jeannette Milgrom

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  1. Jeannette Milgrom
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  2. Charlene Holt
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  3. Christopher J. Holt
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  5. Jennifer Ericksen
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  6. Alan W. Gemmill
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Correspondence to Alan W. Gemmill.

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Milgrom, J., Holt, C., Holt, C.J. et al. Feasibility study and pilot randomised trial of an antenatal depression treatment with infant follow-up. Arch Womens Ment Health 18, 717–730 (2015). https://doi.org/10.1007/s00737-015-0512-5

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