title: A randomized controlled trial: effects of a prenatal depression intervention on perinatal outcomes among Chinese high-risk pregnant women with medically defined complications.
abstract: Prenatal psychosocial health has been linked with health behaviors, maternal health, and birth outcomes. This randomized controlled trial evaluated the effects of a prenatal depression intervention on birth outcomes and maternal physical and psychological status at 42 days postpartum. Three hundred fifty-two high-risk pregnant women exposed to obstetric complications with an Edinburgh Postnatal Depression Scale (EPDS) ≥ 9 or a Postpartum Depression Screening Scale (PDSS) ≥ 60 were randomly assigned to the intervention group (n = 176) and control group (n = 176). The intervention group underwent a six-session couple-separated psycho-educational program; the control group received the usual care. All participants were asked to complete questionnaires at late pregnancy (>28 weeks), 3 days postpartum, and 42 days postpartum. The intervention group had a significantly lower cesarean rate and shorter third stage of labor (p < .05). At 42 days after delivery, only 5.1% of participants were lost to follow-up, and the intervention group had significantly less minor and major depression, more sleep time, more satisfaction with their husband and other family members, less concern about taking care of baby, and less breast milk insufficiency than the control group (p < .05). A prenatal psychological intervention model for high-risk pregnant women holds potential as a preventive program that addresses maternal health and birth outcomes.
  
  
  
  Chinese Clinical Trial Registry (ChiCTR-IOR-15006433), http://www.chictr.org.cn/enIndex.aspx (retrospectively registered).
authors.affiliation: School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, People's Republic of China.|Psychiatry Department, Fudan University Affiliated Huashan Hospital, No. 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: School of Nursing, University of Michigan, 400N. Ingalls, Ann Arbor, MI, 48109, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Munro-Kramer
authors.affiliation: Psychiatry Department, Fudan University Affiliated Huashan Hospital, No. 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China. shishenxun@163.com.
authors.forename: Shenxun
authors.initials: S
authors.lastname: Shi
authors.affiliation: Fudan University Affiliated Obstetrics and Gynecology Hospital, No.128 Shenyang Road, Shanghai, 200090, People's Republic of China. wangjing1172@sina.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Biostatistics, School of Public Health, Fudan University, No.130 Dongan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Luo
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D019052:Depression, Postpartum / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000523:psychology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Birth outcome; Group intervention; Obstetrical complications; Postpartum depression