Effectiveness of a psycho-educational intervention for expecting parents to prevent postpartum parenting stress, depression and anxiety: a randomized controlled trial

Abstract

Background The first months postpartum can be challenging for parents, leading to elevated symptoms of parenting stress, depression and anxiety. In turn, distressed parents are at higher risk for providing suboptimal quality of caregiving. As psychoeducational interventions can be effective in reducing psychological distress, the goal of this randomized controlled trial was to examine the effectiveness of low-intensity universal psychoeducational program to prevent postpartum parenting stress, and to enhance parental well-being and caregiving quality. Method Between 26 and 34 weeks of pregnancy, 138 pregnant women and 96 partners were randomized to the intervention or a waitlist control group. The intervention consisted of a booklet, a video, a home visit, and a telephone call. Information was provided on (1) sensitive responsiveness, adapting to the parental role, and attending to own needs; (2) crying patterns; (3) feeding (arrangements); and (4) sleeping (arrangements). The primary outcome was parenting stress postpartum. Secondary outcomes were additional measures of distress (depression and anxiety), parental well-being, and caregiving quality. Results Both groups showed a rise in distress after birth. No between-group differences were observed on parenting stress, nor on the secondary outcomes. The intervention was rated as useful and of added value by the parents. Conclusion This study offered no evidence that our universal prevention program was effective in decreasing parental distress or in increasing caregiving quality. However, parents found aspects of the intervention useful. More research is needed, including a longer period of follow-up as well as observational measures of parents’ responsiveness. Trial registration This trial has been registered on 15 September 2016 in the Netherlands National Trial Register, ID: NTR6065, https://www.trialregister.nl/trial/5782.

Effectiveness of digital psychotherapeutic intervention among perinatal women: A systematic review and meta-analysis of randomized controlled trials

“…Table 1 summarizes the characteristics of 3239 perinatal women in the 25 included RCTs from 2009[ 85 ] to 2020[ 77 ] in Australia[ 73 , 75 ], Canada[ 81 ], China[ 84 ], Germany[ 70 , 71 ], Iran[ 67 ], Netherlands[ 66 , 76 , 76 ], Portugal[ 64 ], Scotland[ 72 ], Singapore[ 68 ], Sweden[ 65 , 74 , 78 ], Switzerland[ 82 , 83 ], the United States of America[ 62 , 63 , 69 , 85 ], the United Kingdom[ 79 , 80 ], and 23 countries[ 61 ]. The RCTs were two armed ( k = 22) or three armed ( k = 3)[ 67 , 68 , 74 ].…”

“…They were conducted in hospital ( k = 2)[ 68 , 84 ] or in the community ( k = 23). The populations studied included healthy antenatal[ 61 , 62 , 74 , 76 , 77 ] and postnatal[ 68 , 85 ] women and women who experienced psychological problems[ 64 - 67 , 73 , 75 , 77 - 81 , 84 ], insomnia[ 63 , 69 ], preterm labor[ 82 , 83 ], miscarriage[ 72 ], or pregnancy loss[ 70 , 71 ]. The sample size ranged from 25[ 62 ] to 910[ 80 ].…”

“…A total of 19 RCTs[ 62 , 65 - 76 , 78 - 81 , 84 , 85 ] considered depression symptoms as the outcome among 1736 perinatal women by using various measures. Meta-analysis results observed that digital psychotherapeutic intervention had a medium effect size ( g = 0.49) in alleviating depression symptoms significantly (Z = -3.75, P < 0.001) compared with the control.…”

“…Fourteen RCTs[ 65 , 66 , 70 - 73 , 75 , 76 , 78 , 79 , 81 , 82 , 84 , 85 ] assessed the effectiveness of digital psychotherap-eutic intervention in 1091 perinatal women by using anxiety as an outcome. Meta-analysis results indicated that digital psychotherapeutic intervention exerted a significant effect on improving anxiety symptoms ( Z = -5.72, P = 0.007), with a small effect size ( g = 0.25), as shown Figure 4 .…”

“…Moderate heterogeneity ( I 2 = 50.70%) was also found. Another 10 RCTs[ 70 , 71 , 73 - 76 , 78 , 81 , 82 , 85 ] used stress as an outcome in 720 perinatal women. Meta-analysis results demonstrated that stress symptoms were significantly reduced ( Z = -2.90, P < 0.001) in the intervention group with a medium effect size ( g = 0.47) compared with the comparator (Figure 5 ).…”