Objectives

Given stress, anxiety, and depression affect 15–25% of women during pregnancy and are associated with adverse outcomes for maternal and child health if untreated, a randomized controlled trial evaluated the effectiveness of an 8-week modified Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) intervention for psychological distress.

Methods

A community sample of pregnant women who self-identified as experiencing high levels of psychological distress was randomized into MBCT-PD (n = 28) or treatment as usual (n = 32). Participants completed online questionnaires assessing symptoms of distress, pregnancy and generalized anxiety, depression, and stress during lab visits at enrolment (before allocation), immediately following the intervention, and at follow-up (3 months postpartum). Women also reported delivery type and gestational age of their newborn.

Results

Using an intention-to-treat approach, multilevel modeling indicated a significant effect of MBCT-PD treatment on overall psychological distress, but not on other symptoms. Path analysis revealed a moderated mediation, with an indirect effect of MBCT-PD treatment on lengthening gestational age through decreasing pregnancy anxiety among women with higher baseline symptoms.

Conclusions

In pregnant women seeking treatment for high levels of psychological distress, MBCT-PD was associated with improved overall distress, but not other specific symptoms such as anxiety and depression beyond treatment as usual. MBCT-PD has the potential to reduce the risk of preterm birth by targeting and reducing high levels of pregnancy anxiety during early gestation. Further research is warranted to examine other outcomes (e.g., coping skills, interpersonal functioning) and comparisons to other interventions.

中文翻译：

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怀孕中基于正念的认知疗法对心理困扰和妊娠年龄的影响：随机对照试验的结果。

目标

考虑到压力，焦虑和抑郁症在怀孕期间会影响15-25％的妇女，并且如果不进行治疗，则会对母婴健康产生不良后果，因此，一项随机对照试验评估了为期8周的基于正念的认知疗法对围产期妇女的有效性抑郁症（MBCT-PD）干预可缓解心理困扰。

方法

自我鉴定为患有高水平心理困扰的孕妇社区样本被随机分为MBCT-PD（n = 28）或照常治疗（n = 32）。参与者完成在线问卷调查，以评估在入组时（分配前），干预后以及随访（产后3个月）在实验室就诊时的困扰，妊娠和广泛性焦虑，抑郁和压力症状。妇女还报告了新生儿的分娩类型和胎龄。

结果

使用意向性治疗方法，多层次建模表明MBCT-PD治疗对整体心理困扰有显著作用，而对其他症状无影响。路径分析揭示了中等程度的调解，通过降低基线症状较高的妇女的妊娠焦虑，MBCT-PD治疗间接延长了胎龄。

结论

在寻求针对高度心理困扰的治疗的孕妇中，MBCT-PD与总体困扰有所改善相关，但与其他通常的治疗方法相比，其他症状如焦虑和抑郁并没有改善。MBCT-PD有可能通过针对和减少早孕期间的高水平妊娠焦虑来降低早产风险。有必要进行进一步的研究以检查其他结果（例如，应对技巧，人际交往功能）以及与其他干预措施的比较。