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Purpose <p>While interventions to mitigate and prevent perinatal maternal distress exist, none are personalized based on participants’ daily experiences and intervention response. This study compared maternal distress outcomes (depressive symptoms, anxiety symptoms, perceived stress) between perinatal individuals receiving a personalized mobile health-enhanced cognitive-behavioral intervention and individuals receiving usual prenatal care.</p> Methods <p>Pregnant individuals <i>≤</i> 22 weeks’ gestation recruited from six prenatal care clinics were randomized to the intervention or usual prenatal care. Intervention participants received a 12-session adaptation of the Mothers and Babies intervention (MB-P), personalized by just-in-time stress reduction and mindfulness content based on elevated physiologic or self-reported stress. Primary outcomes were depressive and anxiety symptoms, and perceived stress. Secondary outcomes were behavioral activation, decentering of thoughts, social support, and mood regulation. Outcomes were measured at baseline, one-week post-intervention, one month postpartum, and three months postpartum. An intent-to-treat approach using mixed-effects models guided analysis.</p> Results <p>Forty-nine individuals were randomized to MB-P and fifty-one to usual prenatal care. Participants were 70% White, 33.7 years old on average, and 16.2 weeks gestation. At three months postpartum, intervention participants had lower depressive symptomatology (d = 0.43) and less perceived stress (d = 0.46) than controls. Intervention participants exhibited greater behavioral activation three months postpartum (d = 0.41), greater decentering post-intervention (d = 0.37), and greater mood regulation post-intervention (d = 0.56) and three months postpartum (d = 0.55).</p> Conclusion <p>MB-P improved maternal depression and anxiety and mechanisms of behavioral activation, decentering, and mood regulation when compared to usual prenatal care. Future research should examine MB-P impact compared to standard MB without just-in-time content.</p> <p>Trial registration:&#xa0;Clinical Trials.gov, NCT05052281.</p>

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Effects of a Personalized Stress Management Intervention on Maternal Mental Health: A Randomized Clinical Trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月17日

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  • S. Darius Tandon,
  • Judith T. Moskowitz,
  • Renee C. Edwards,
  • Yudong Zhang,
  • Gina Giase,
  • Brianna Sinche,
  • Abigail L. Blum,
  • S Krislov,
  • Haley M. Reynolds,
  • Aditi Rangarajan,
  • Peter Cummings,
  • Amélie Petitclerc,
  • Nabil Alshurafa,
  • William A. Grobman,
  • Erin A. Ward,
  • Lauren S. Wakschlag

摘要

Purpose

While interventions to mitigate and prevent perinatal maternal distress exist, none are personalized based on participants’ daily experiences and intervention response. This study compared maternal distress outcomes (depressive symptoms, anxiety symptoms, perceived stress) between perinatal individuals receiving a personalized mobile health-enhanced cognitive-behavioral intervention and individuals receiving usual prenatal care.

Methods

Pregnant individuals ≤ 22 weeks’ gestation recruited from six prenatal care clinics were randomized to the intervention or usual prenatal care. Intervention participants received a 12-session adaptation of the Mothers and Babies intervention (MB-P), personalized by just-in-time stress reduction and mindfulness content based on elevated physiologic or self-reported stress. Primary outcomes were depressive and anxiety symptoms, and perceived stress. Secondary outcomes were behavioral activation, decentering of thoughts, social support, and mood regulation. Outcomes were measured at baseline, one-week post-intervention, one month postpartum, and three months postpartum. An intent-to-treat approach using mixed-effects models guided analysis.

Results

Forty-nine individuals were randomized to MB-P and fifty-one to usual prenatal care. Participants were 70% White, 33.7 years old on average, and 16.2 weeks gestation. At three months postpartum, intervention participants had lower depressive symptomatology (d = 0.43) and less perceived stress (d = 0.46) than controls. Intervention participants exhibited greater behavioral activation three months postpartum (d = 0.41), greater decentering post-intervention (d = 0.37), and greater mood regulation post-intervention (d = 0.56) and three months postpartum (d = 0.55).

Conclusion

MB-P improved maternal depression and anxiety and mechanisms of behavioral activation, decentering, and mood regulation when compared to usual prenatal care. Future research should examine MB-P impact compared to standard MB without just-in-time content.

Trial registration: Clinical Trials.gov, NCT05052281.