A pilot study on the ameliorative effect of "Mom’s Good Mood" on antenatal depression_Chinese Journal of Evidence-Based Medicine

Authors：

HOU Yanyan ^1,2,3,4 , ZHU Beibei ^1,2,3,4 , LU Mengjuan ^1,2,3,4 , JIANG Minmin ^2,3,5 , YU Xiayan ^1,2,3,4 , GU Yue ^1,2,3,4 , LI Haiyan ^1,2,3,4 ,  TAO Fangbiao ^1,2,3,4

1. Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, P. R. China;
2. Key Laboratory of Population Health Across Life Cycle, Ministry of Education, Hefei 230032, P. R. China;
3. Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, P. R. China;
4. Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, P. R. China;
5. Department of Occupational Health and Environmental Health, Anhui Medical University, Hefei 230032, P. R. China;

Corresponding author：

TAO Fangbiao, Email: fbtao@ahmu.edu.cn

Keywords：

Antenatal depression; Internet; Mom’s Good Mood; Cognitive behavioral therapy; Pilot study; Intervention study

DOI：

10.7507/1672-2531.202204129

Video：

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Objective To preliminarily assess the ameliorative effect of Mom’s Good Mood (MGM) on the prevalence of antenatal depression based on a pilot study, and to provide evidence for a scale-up study. Methods This study was conducted in Ma’anshan Maternal and Child Health Center as a pilot study of an implementation study conducted in China called the Perinatal Depression Screening and Management (PDSM) program. In 2019, 1 189 participants (gestational week ≤14⁺⁶ weeks) were included in the implementation group. Females were recruited in the first trimester and followed up in the second and third trimesters. At each time point, the participants’ depression status was screened by the Edinburgh postpartum depression scale (EPDS), and those who were screened as having depression were provided the MGM intervention. In 2020, 1 708 participants who underwent screening with the EPDS in either the first, second or third trimester at Ma’anshan Maternal and Child Health Center were included in the control group. Mann‒Whitney U test, Chi-square, and multivariate logistic regression analysis were used to compare the EPDS scores and depression prevalence between the control and implementation groups to assess the ameliorative effect of MGM (screening and intervention) on antenatal depression. Results In the first trimester, there were no statistically significant differences in EPDS scores or depression prevalence between the two groups (P>0.05). In the second and third trimesters, both the EPDS scores and depression prevalence of the implementation group were lower than those of the control group (P<0.05). After adjusting for confounders, logistic regression analysis showed that the risks of depression in the implementation group in both the second and third trimesters were lower than those in the control group (OR_{second trimester}=0.55, 95%CI 0.37 to 0.81, P=0.003; OR_{third trimester}=0.51, 95%CI 0.35 to 0.74, P<0.001). Conclusion Implementation of the MGM based on the primary care system can effectively reduce the prevalence of antenatal depression, providing evidence for further scale up.

Citation： HOU Yanyan, ZHU Beibei, LU Mengjuan, JIANG Minmin, YU Xiayan, GU Yue, LI Haiyan, TAO Fangbiao. A pilot study on the ameliorative effect of "Mom’s Good Mood" on antenatal depression. Chinese Journal of Evidence-Based Medicine, 2022, 22(9): 1012-1019. doi: 10.7507/1672-2531.202204129 Copy

1.	肖霄, 朱社宁, 张旱愉, 等. 产前抑郁概念分析. 护理学报, 2017, 24(19): 18-23.
2.	Gelaye B, Rondon MB, Araya R, et al. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry, 2016, 3(10): 973-982.
3.	Becker M, Weinberger T, Chandy A, et al. Depression during pregnancy and postpartum. Curr Psychiatry Rep, 2016, 18(3): 32.
4.	Li X, Gao R, Dai X, et al. The association between symptoms of depression during pregnancy and low birth weight: a prospective study. BMC Pregnancy Childbirth, 2020, 20(1): 147.
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13.	Mitchell LM, Joshi U, Patel V, et al. Economic evaluations of internet-based psychological interventions for anxiety disorders and depression: a systematic review. J Affect Disord, 2021, 284: 157-182.
14.	Proctor EK, Landsverk J, Aarons G, et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health, 2009, 36(1): 24-34.
15.	Tsai AC, Scott JA, Hung KJ, et al. Reliability and validity of instruments for assessing perinatal depression in African settings: systematic review and meta-analysis. PLoS One, 2013, 8(12): e82521.
16.	Pop VJ, Komproe IH, van Son MJ. Characteristics of the Edinburgh post natal depression scale in the Netherlands. J Affect Disord, 1992, 26(2): 105-110.
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19.	陈志红, 付冰, 米春梅, 等. 产前抑郁干预措施的研究进展. 中国护理管理, 2017, 17(5): 686-691.
20.	Robertson E, Grace S, Wallington T, et al. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry, 2004, 26(4): 289-295.
21.	Hayes BA. From 'postnatal depression' to 'perinatal anxiety and depression': key points of the National Perinatal Depression Plan for nurses and midwives in Australian primary health care settings. Contemp Nurse, 2010, 35(1): 58-67.
22.	Shortis E, Warrington D, Whittaker P. The efficacy of cognitive behavioral therapy for the treatment of antenatal depression: a systematic review. J Affect Disord, 2020, 272: 485-495.
23.	韩书勤, 张庆悦. 心理干预对降低产前抑郁致婴儿早产的研究. 实用妇科内分泌电子杂志, 2017, 4(9): 55-56.
24.	康红, 何玉凤, 吉翠琴. 共情护理联合放松训练对先兆早产孕妇抑郁及妊娠结局的影响. 中国初级卫生保健, 2020, 34(1): 58-61.
25.	Sockol LE. A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression. J Affect Disord, 2015, 177: 7-21.
26.	谢润生, 徐东, 李慧, 等. 医疗卫生领域中实施科学的研究方法. 中国循证医学杂志, 2020, 20(9): 1104-1110.
27.	Premji SS, Dobson KS, Prashad A, et al. What stakeholders think: perceptions of perinatal depression and screening in China's primary care system. BMC Pregnancy Childbirth, 2021, 21(1): 15.
28.	鹿孟娟. 基于初级卫生保健系统孕期抑郁筛查与管理的实施及阶段性评估: 一项混合研究. 合肥: 安徽医科大学, 2020.
29.	Schwank SE, Andersson E, Wickberg B, et al. Care-seeking behavior and disclosure on self-reported mental health among young women in urban Shanghai, China. Health Psychol Open, 2020, 7(1): 2055102919897382.

1. 肖霄, 朱社宁, 张旱愉, 等. 产前抑郁概念分析. 护理学报, 2017, 24(19): 18-23.
2. Gelaye B, Rondon MB, Araya R, et al. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry, 2016, 3(10): 973-982.
3. Becker M, Weinberger T, Chandy A, et al. Depression during pregnancy and postpartum. Curr Psychiatry Rep, 2016, 18(3): 32.
4. Li X, Gao R, Dai X, et al. The association between symptoms of depression during pregnancy and low birth weight: a prospective study. BMC Pregnancy Childbirth, 2020, 20(1): 147.
5. 李粉, 田友平, 刘晓敏, 等. 母亲孕期抑郁与2岁儿童行为问题关系的前瞻性队列研究. 中华流行病学杂志, 2018, 39(4): 455-459.
6. Patel V, Xiao S, Chen H, et al. The magnitude of and health system responses to the mental health treatment gap in adults in India and China. Lancet, 2016, 388(10063): 3074-3084.
7. Schwank SE, Zhou Q, He Y, et al. Perinatal mental health around the world: priorities for research and service development in China. BJPsych Int, 2020, 17(3): 50-53.
8. World Health Organization. Thinking healthy: a manual for psychosocial management of perinatal depression, WHO generic field-trial version 1.0, 2015. Available at: https://apps.who.int/iris/handle/10665/152936.
9. Rahman A, Malik A, Sikander S, et al. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet, 2008, 372(9642): 902-909.
10. Atif N, Krishna RN, Sikander S, et al. Mother-to-mother therapy in India and Pakistan: adaptation and feasibility evaluation of the peer-delivered Thinking Healthy Programme. BMC Psychiatry, 2017, 17(1): 79.
11. Eappen BS, Aguilar M, Ramos K, et al. Preparing to launch the 'Thinking Healthy Programme' perinatal depression intervention in Urban Lima, Peru: experiences from the field. Glob Ment Health (Camb), 2018, 5: e41.
12. Vanobberghen F, Weiss HA, Fuhr DC, et al. Effectiveness of the Thinking Healthy Programme for perinatal depression delivered through peers: pooled analysis of two randomized controlled trials in India and Pakistan. J Affect Disord, 2020, 265: 660-668.
13. Mitchell LM, Joshi U, Patel V, et al. Economic evaluations of internet-based psychological interventions for anxiety disorders and depression: a systematic review. J Affect Disord, 2021, 284: 157-182.
14. Proctor EK, Landsverk J, Aarons G, et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health, 2009, 36(1): 24-34.
15. Tsai AC, Scott JA, Hung KJ, et al. Reliability and validity of instruments for assessing perinatal depression in African settings: systematic review and meta-analysis. PLoS One, 2013, 8(12): e82521.
16. Pop VJ, Komproe IH, van Son MJ. Characteristics of the Edinburgh post natal depression scale in the Netherlands. J Affect Disord, 1992, 26(2): 105-110.
17. Gibson J, McKenzie-McHarg K, Shakespeare J, et al. A systematic review of studies validating the Edinburgh postnatal depression scale in antepartum and postpartum women. Acta Psychiatr Scand, 2009, 119(5): 350-364.
18. 胡焕青, 张继, 赵薇, 等. 中国6个县/区孕妇孕期焦虑, 抑郁发生状况及影响因素. 中华预防医学杂志, 2017, 51(1): 47-52.
19. 陈志红, 付冰, 米春梅, 等. 产前抑郁干预措施的研究进展. 中国护理管理, 2017, 17(5): 686-691.
20. Robertson E, Grace S, Wallington T, et al. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry, 2004, 26(4): 289-295.
21. Hayes BA. From 'postnatal depression' to 'perinatal anxiety and depression': key points of the National Perinatal Depression Plan for nurses and midwives in Australian primary health care settings. Contemp Nurse, 2010, 35(1): 58-67.
22. Shortis E, Warrington D, Whittaker P. The efficacy of cognitive behavioral therapy for the treatment of antenatal depression: a systematic review. J Affect Disord, 2020, 272: 485-495.
23. 韩书勤, 张庆悦. 心理干预对降低产前抑郁致婴儿早产的研究. 实用妇科内分泌电子杂志, 2017, 4(9): 55-56.
24. 康红, 何玉凤, 吉翠琴. 共情护理联合放松训练对先兆早产孕妇抑郁及妊娠结局的影响. 中国初级卫生保健, 2020, 34(1): 58-61.
25. Sockol LE. A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression. J Affect Disord, 2015, 177: 7-21.
26. 谢润生, 徐东, 李慧, 等. 医疗卫生领域中实施科学的研究方法. 中国循证医学杂志, 2020, 20(9): 1104-1110.
27. Premji SS, Dobson KS, Prashad A, et al. What stakeholders think: perceptions of perinatal depression and screening in China's primary care system. BMC Pregnancy Childbirth, 2021, 21(1): 15.
28. 鹿孟娟. 基于初级卫生保健系统孕期抑郁筛查与管理的实施及阶段性评估: 一项混合研究. 合肥: 安徽医科大学, 2020.
29. Schwank SE, Andersson E, Wickberg B, et al. Care-seeking behavior and disclosure on self-reported mental health among young women in urban Shanghai, China. Health Psychol Open, 2020, 7(1): 2055102919897382.

Chinese Journal of Evidence-Based Medicine

A pilot study on the ameliorative effect of "Mom’s Good Mood" on antenatal depression

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