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An intervention to reduce postpartum depressive symptoms: a randomized controlled trial

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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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Authors and Affiliations

  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

    Elizabeth A. Howell, Susan Bodnar-Deren, Amy Balbierz & Jason Wang

  2. Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Elizabeth A. Howell & Holly Loudon

  3. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Elizabeth A. Howell

  4. Psychology Department, University of Texas at Arlington, Arlington, USA

    Pablo A. Mora

  5. Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Women and Infants Hospital, Providence, RI, USA

    Caron Zlotnick

  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

    Howard Leventhal

  7. Department of Sociology, Virginia Commonwealth University, 923 W. Franklin Street, Office 509, Richmond, VA, 23284-2040, USA

    Susan Bodnar-Deren

Authors
  1. Elizabeth A. Howell
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  2. Susan Bodnar-Deren
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  3. Amy Balbierz
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  4. Holly Loudon
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  5. Pablo A. Mora
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  6. Caron Zlotnick
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  7. Jason Wang
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  8. Howard Leventhal
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Corresponding author

Correspondence to Elizabeth A. Howell.

Additional information

Supported by the National Institute of Mental Health (5R01MH77683) and the National Institute on Minority Health and Health Disparities (5P60MD000270).

Clinical trial registration

Clinicaltrials.gov, www.clinicaltrials.gov, NCT00951717

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Howell, E.A., Bodnar-Deren, S., Balbierz, A. et al. An intervention to reduce postpartum depressive symptoms: a randomized controlled trial. Arch Womens Ment Health 17, 57–63 (2014). https://doi.org/10.1007/s00737-013-0381-8

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  • DOI: https://doi.org/10.1007/s00737-013-0381-8

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