title: Feasibility study and pilot randomised trial of an antenatal depression treatment with infant follow-up.
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.
authors.affiliation: Parent-Infant Research Institute, Austin Health, 300 Waterdale Road, Heidelberg West, VIC, 3081, Australia.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Milgrom
authors.forename: Charlene
authors.initials: C
authors.lastname: Holt
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Holt
authors.forename: Jessica
authors.initials: J
authors.lastname: Ross
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ericksen
authors.forename: Alan W
authors.initials: AW
authors.lastname: Gemmill
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D010555:Personality Inventory; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011256:Pregnancy Outcome; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome