Optimizing Perinatal Maternal Mental Health and Weight Gain by Combining an Electronic Mindfulness-based Intervention with Face-to-Face Coaching: Sub-analysis of a Randomized Controlled Clinical Trial (Preprint)

Abstract

Perinatal maternal mental health problems, such as depression and anxiety, are highly prevalent during pregnancy and postpartum. A promising treatment option is the use of electronic mindfulness-based interventions (eMBI), which can be provided in a low-threshold and cost-effective manner. However, research underscores the fact that face-to-face coaching sessions are more effective than solely digital methods. A synergistic approach, combining eMBI with direct face-to-face coaching, could potentially amplify the therapeutic impact on maternal mental health and weight gain during the perinatal period.

The aim of the present study was to investigate whether combining an eMBI intervention with face-to-face personal support significantly reduces perinatal maternal mental health. Furthermore, we aimed to investigate whether the intervention can influence weight gain in affected women during pregnancy.

A community-based sample of N = 460 pregnant women with a singleton pregnancy and screened positive for depressiveness was enrolled in a multicenter randomized controlled trial (RCT, the mindmom study). Participating women were randomized 1:1 to the control group (CG) or intervention group (IG) that received access to an 8-week pregnancy-adapted eMBI between the 29th and 36th gestational week . In a sub-analysis, we grouped the participants in those receiving only the initial face-to-face coaching session at recruitment (NPC = no personal coaching) and those with two or more personal coaching (PC) sessions. Primary outcome measures were severity of depressive symptoms, anxiety, and pregnancy- and birth-related anxiety. Body mass index (BMI) was assessed as a secondary outcome measure.

In the final sample, 137 women in the control group and 102 women in the intervention group received only one coaching session, whereas 37 women in the control group and 40 in the intervention group received at least two coaching sessions (M = 2.3). The analyses were adjusted for significant confounders. In the intervention group, mindfulness scores increased significantly (F = 7.522; p = 0.001; η ² = 0.039) and pregnancy- and birth-related anxiety decreased significantly (F = 3.590; p = 0.011; η ² = 0.016), regardless of the coaching frequency. Both general anxiety (F = 2.582; p = 0.030; η ² = 0.018) and symptoms of depression (F = 3.159; p = 0.009; η ² = 0.021) were significantly lower in the group that received two (or more) coaching sessions than in the NPC group. In the PC group, BMI generally was lower in the IG than in the CG.

Adding a minimal amount of PC to the digital eMBI increased mindfulness and decreased birth-related anxiety, symptoms of depression, and anxiety in at-risk pregnant women. Favorable effects on gestational weight gain (GWG) were found in the respective IGs, the strongest effect being within the PC group. This blended digital health approach amplifies the effectiveness of the digital intervention.

Deutsches Register Klinischer Studien, German Clinical Trials Register DRKS00017210