title: An intervention to reduce postpartum depressive symptoms: a randomized controlled trial.
abstract: Depressive symptoms and depression are a common complication of childbirth, and a growing body of literature suggests that there are modifiable factors associated with their occurrence. We developed a behavioral educational intervention targeting these factors and successfully reduced postpartum depressive symptoms in a randomized trial among low-income black and Latina women. We now report results of 540 predominantly white, high-income mothers in a second randomized trial. Mothers in the intervention arm received a two-step intervention that prepared and educated mothers about modifiable factors associated with postpartum depressive symptoms (e.g., physical symptoms, low self-efficacy), bolstered social support, and enhanced management skills. The control arm received enhanced usual care. Participants were surveyed prior to randomization, 3 weeks, 3 months, and 6 months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS of 10 or greater). Prevalence of depressive symptoms postpartum was unexpectedly low precluding detection of difference in rates of depressive symptoms among intervention versus enhanced usual care posthospitalization: 3 weeks (6.0 vs. 5.6 %, p = 0.83), 3 months (5.1 vs. 6.5 %, p = 0.53), and 6 months (3.6 vs. 4.6 %, p = 0.53).
authors.affiliation: Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029-6574, USA, elizabeth.howell@mountsinai.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Howell
authors.forename: Susan
authors.initials: S
authors.lastname: Bodnar-Deren
authors.forename: Amy
authors.initials: A
authors.lastname: Balbierz
authors.forename: Holly
authors.initials: H
authors.lastname: Loudon
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Mora
authors.forename: Caron
authors.initials: C
authors.lastname: Zlotnick
authors.forename: Jason
authors.initials: J
authors.lastname: Wang
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
mesh_terms: D000293:Adolescent; D000328:Adult; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data; D019052:Depression, Postpartum / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009035:Mothers / Q000193:education* / Q000523:psychology; D009519:New York City / Q000453:epidemiology; D010353:Patient Education as Topic / Q000379:methods*; D011181:Postnatal Care / Q000379:methods*; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D012923:Social Class; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
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