HomeHealthMental HealthPrenatal intervention benefits mothers' mental health up to eight years later

Prenatal intervention benefits mothers’ mental health up to eight years later

A low-cost, prenatal intervention benefits mothers’ mental health up to eight years later, a new study from UC San Francisco finds.

In the study, one of the first to look at results so far in the future, pregnant women who participated in a wellness group that met weekly for eight weeks were half as likely to be depressed eight years later compared to women who received standard care. , according to the study published in the Journal of Consulting and Clinical Psychology.

Previous research in the same group of women found that the intervention also reduced their short-term risk of depression and diabetes and supported healthier stress responses in their children.

Given the economic and social burden of maternal depression and its potential impact on offspring, our findings suggest a meaningful benefit of a modest investment during pregnancy that supports the well-being of two generations.”

Danielle Roubinov, PhD, UCSF assistant professor of psychiatry and first author of the study

The eight-week classroom intervention, led by Elissa Epel, PhD, UCSF professor of psychiatry and her team, involved groups of eight to 10 pregnant women who met for two hours a week to practice mindfulness-based stress reduction exercises, focusing primarily on on mindful eating, breathing and moving. They were led through group classes and activities by a master’s level health professional. The women also received two phone sessions and a postpartum “booster” group session with their babies.

BIPOC study participants had priority

Historically, most prenatal depression studies have consisted primarily of white women — but not this one, noted Nicki Bush, PhD, a professor of pediatrics and psychiatry at the UCSF Weill Institute for Neurosciences and senior author on the study.

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“Our participants were lower-income women, racially and ethnically diverse, who are systematically exposed to factors that put them at risk for depression, such as racism and economic hardship,” Bush said. “In addition, the final years of the study were during the COVID-19 pandemic, when depression rates were higher for everyone and the burden on communities of color was even greater. Still, the treatment effects held up.”

In the study, 162 women were assigned to either the intervention group or standard care group. The women’s depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9) before the wellness intervention classes, after the wellness classes, and 1, 2, 3-4, 5, 6, and 8 years later.

While both groups of women had similar symptoms of depression before class, 12 percent of women who were part of the wellness class reported moderate or severe depressive symptoms after eight years, compared to 25 percent of women who received standard care, which was a consistent pattern over the years.

“Mindfulness is known to help relieve stress in many situations and can have a meaningful impact on coping and health, and it appears to have been especially powerful here during pregnancy, with lasting effects,” Bush said. “Our feeling is that the community connections and social support involved in the (wellness class) group was also therapeutic.”

Stress management, diet and exercise during pregnancy

The researchers are currently collecting additional data to better understand how the intervention had such a long-term effect. Possible mechanisms include long-term changes in coping and stress reactivity, diet and exercise.

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Up to 27 percent of pregnant women suffer from prenatal depression, which is predictive of postnatal depression. Maternal depression is also associated with social, emotional, and cognitive deficits in the offspring.

“This dramatic demonstration of both short-term reduction in depressive symptoms and long-term prevention of more severe maternal depression, even during the pandemic, is remarkable even for us researchers,” Epel said. “It is likely that the effects of increased stress tolerance in these women have pervasive effects on their own health and their children. We would never have known how lasting these changes are if Dr. Bush and her team had not followed them for eight years. We know already that pregnancy is a critical period and the lesson here is that we need to invest heavily in pregnancy wellness interventions.”

The researchers hope that the low cost and relatively short time commitment of the intervention class will make it easy to scale up to larger groups of pregnant women; especially women of color and people with lower incomes.

“It is critical to have interventions that meet the needs of lower-income people, Blacks, Indigenous peoples and people of color, who will especially experience the stress of social inequality,” Roubinov said. “We are excited to see how these results can be scaled up to reach more women and a more diverse pool of women.”


Magazine reference:

Stice, E & Davila, J., et al. (2022) Introduction to the special issue of the Journal of Consulting and Clinical Psychology: “Best Practices” in Prevention and Treatment of People of Racial and Ethnic Minorities. Journal of Consulting and Clinical Psychology. doi.org/10.1037/ccp0000767.

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