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An intervention to reduce postpartum depressive symptoms: a randomized controlled trial
Authors:Elizabeth A. Howell  Susan Bodnar-Deren  Amy Balbierz  Holly Loudon  Pablo A. Mora  Caron Zlotnick  Jason Wang  Howard Leventhal
Affiliation:1. Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029-6574, USA
2. Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
3. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
7. Department of Sociology, Virginia Commonwealth University, 923 W. Franklin Street, Office 509, Richmond, VA, 23284-2040, USA
4. Psychology Department, University of Texas at Arlington, Arlington, USA
5. Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Women and Infants Hospital, Providence, RI, USA
6. Institute for Health, Health Care Policy and Aging Research and Department of Psychology, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
Abstract:Depressive symptoms and depression are a common complication of childbirth, and a growing body of literature suggests that there are modifiable factors associated with their occurrence. We developed a behavioral educational intervention targeting these factors and successfully reduced postpartum depressive symptoms in a randomized trial among low-income black and Latina women. We now report results of 540 predominantly white, high-income mothers in a second randomized trial. Mothers in the intervention arm received a two-step intervention that prepared and educated mothers about modifiable factors associated with postpartum depressive symptoms (e.g., physical symptoms, low self-efficacy), bolstered social support, and enhanced management skills. The control arm received enhanced usual care. Participants were surveyed prior to randomization, 3 weeks, 3 months, and 6 months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS of 10 or greater). Prevalence of depressive symptoms postpartum was unexpectedly low precluding detection of difference in rates of depressive symptoms among intervention versus enhanced usual care posthospitalization: 3 weeks (6.0 vs. 5.6 %, p?=?0.83), 3 months (5.1 vs. 6.5 %, p?=?0.53), and 6 months (3.6 vs. 4.6 %, p?=?0.53).
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