title: Prenatal emotion management improves obstetric outcomes: a randomized control study.
abstract: BACKGROUND
  Negative emotions can cause a number of prenatal problems and disturb obstetric outcomes. We determined the effectiveness of prenatal emotional management on obstetric outcomes in nulliparas.
  
  
  METHODS
  All participants completed the PHQ-9 at the baseline assessment. Then, the participants were randomly assigned to the emotional management (EM) and usual care (UC) groups. The baseline evaluation began at 31 weeks gestation and the participants were followed up to 42 days postpartum. Each subject in the EM group received an extra EM program while the participants in the UC groups received routine prenatal care and education only. The PHQ-9 and Edinburgh Postnatal Depression scale (EPDS) were used for assessment.
  
  
  RESULTS
  The EM group had a lower PHQ-9 score at 36 weeks gestation, and 7 and 42 days after delivery (P < 0.01), and a lower EPDS score 42 days postpartum (P < 0.05). The rate of cesarean section in the EM group was lower than the UC group (P < 0.01), and the cesarean section rate without a medical indication was lower (P < 0.01). The duration of the second stage of labor in the EM group was shorter than the UC group (P < 0.01).
  
  
  CONCLUSIONS
  Prenatal EM intervention could control anxiety and depressive feelings in nulliparas, and improve obstetric outcomes. It may serve as an innovative approach to reduce the cesarean section rate in China.
authors: Department of Obstetrics and Gynecology, The First People's Hospital of Hangzhou Hangzhou, China.
authors: Jian
authors: J
authors: Huang
authors: Department of Obstetrics and Gynecology, The First People's Hospital of Hangzhou Hangzhou, China.
authors: He-Jiang
authors: HJ
authors: Li
authors: Department of Obstetrics and Gynecology, The First People's Hospital of Hangzhou Hangzhou, China.
authors: Jue
authors: J
authors: Wang
authors: Department of Medical Psychology, The Seventh People's Hospital of Hangzhou Hangzhou, China.
authors: Hong-Jing
authors: HJ
authors: Mao
authors: Department of Obstetrics and Gynecology, The First People's Hospital of Hangzhou Hangzhou, China.
authors: Wen-Ying
authors: WY
authors: Jiang
authors: Department of Obstetrics and Gynecology, The First People's Hospital of Hangzhou Hangzhou, China.
authors: Hong
authors: H
authors: Zhou
authors: Department of Psychology, Zhejiang University Hangzhou, China.
authors: Shu-Lin
authors: SL
authors: Chen
keywords: Psychological intervention; cesarean section rate; prenatal period; stage of labor