Abstract
Abstract
Background
As early as pregnancy, maternal mental stress impinges on the child’s development and health. Thus, this may cause enhanced risk for premature birth, lowered fetal growth, and lower fetal birth weight as well as enhanced levels of the stress hormone cortisol and lowered levels of the bonding hormone oxytocin. Maternal stress further reduces maternal sensitivity for the child’s needs which impairs the mother-child-interaction and bonding. Therefore, prevention and intervention studies on mental stress are necessary, beginning prenatally and applying rigorous research methodology, such as randomized controlled trials, to ensure high validity.
Methods
A randomized controlled trial is used to assess the impact of psychotherapy and telemedicine on maternal mental stress and the child’s mental and physical health. Mentally stressed pregnant women are randomized to an intervention (IG) and a not intervened control group. The IG receives an individualized psychotherapy starting prenatal and lasting for 10 months. Afterwards, a second randomization is used to investigate whether the use of telemedicine can stabilize the therapeutic effects. Using ecological momentary assessments and video recordings, the transfer into daily life, maternal sensitivity and mother-child-bonding are assessed. Psycho-biologically, the synchronicity of cortisol and oxytocin levels between mother and child are assessed as well as the peptidome of the colostrum and breast milk, which are assumed to be essential for the adaptation to the extra-uterine environment. All assessments are compared to an additional control group of healthy women. Finally, the results of the study will lead to the development of a qualification measure for health professionals to detect mental stress, to treat it with low-level interventions and to refer those women with high stress levels to mental health professionals.
Discussion
The study aims to prevent the transgenerational transfer of psychiatric and somatic disorders from the mother to her child. The effects of the psychotherapy will be stabilized through telemedicine and long-term impacts on the child’s and mothers’ mental health are enhanced. The combination of psychotherapy, telemedicine and methodologies of ecological momentary assessment, video recording and bio banking are new in content-related and methodological manner.
Trial registration
German Clinical Trials Register: DRKS00017065. Registered 02 May 2019. World Health Organization, Universal Trial Number: U1111–1230-9826. Registered 01 April 2019.
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health
Reference104 articles.
1. Turmes L, Hornstein C. Stationäre Mutter-Kind-Behandlungseinheiten in Deutschland. Nervenarzt. 2007;78(7):773–9.
2. Jungmann T, Pfeiffer C. Zur Notwendigkeit von Prävention für Kinder sozial benachteiligter Familien−eine kriminologische Betrachtung. In: Frühe Risiken und frühe Hilfen. Stuttgart: Grundlagen, Diagnostik, Prävention; 2010.
3. Gawlik S, Waldeier L, Müller M, Szabo A, Sohn C, Reck C. Subclinical depressive symptoms during pregnancy and birth outcome—a pilot study in a healthy German sample. Arch Womens Ment Health. 2013;16:93–100.
4. Fishell A. Depression and anxiety in pregnancy. J Population Therap Clin Pharmacol. 2010;17(3):363–9.
5. Fisher J, de Mello MC, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139–49.
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献