Numerous studies report that some first-time parents experience a decline in relationship quality and an increase in conflict after the birth of a first baby. Inter-parental discord that is frequent, intense, and poorly resolved increases the likelihood of relationship breakdown and adversely impacts child development. We investigated the feasibility of a brief preventative couple-focused psychotherapeutic intervention in the perinatal period in a general population sample. Sixty couples expecting their first baby were recruited from the Royal Free Hospital, London. Thirty were randomly assigned to treatment (TMT, a newly developed five-session couple-focused intervention), and 30 to usual care (TAU). Outcomes were collected at 28 weeks into pregnancy, 6–8 weeks after birth, and when the baby was 6 months old. The intervention was feasible and acceptable, evidenced by 100% attendance. However, no change in relationship quality or inter-parental discord was detected in either TMT or TAU groups across the transition to parenthood. The intervention did not improve outcomes vs. TAU. Depression assessed by the Hospital Anxiety and Depression Scale increased across the cohort and mood symptoms assessed by the Edinburgh Postnatal Depression Scale decreased in mothers but not fathers. The absence of a decline in relationship quality could reflect sample attributes: couples were older than average UK first-time parents, had high levels of educational qualifications, and low discord. Even in this low-risk sample, only 20 out of 30 TAU couples completed all three assessments, vs. 29 out of 30 TMT couples. Larger-scale RCTs of perinatal couple-focused psychosocial interventions may be hampered by selection effects and attrition. They may benefit from co-design with stakeholders and active control conditions.

Trial registration: ISRCTN12258825; 1st May 2020 (retrospectively registered).

许多研究报告说，一些初为父母的人在第一个孩子出生后会经历关系质量下降和冲突增加的经历。频繁、激烈且未得到妥善解决的父母间不和会增加关系破裂的可能性，并对儿童发展产生不利影响。我们在一般人群样本中调查了在围产期进行简短的以夫妻为中心的预防性心理治疗干预的可行性。从伦敦皇家自由医院招募了 60 对期待第一个孩子的夫妇。30 人被随机分配到治疗（TMT，一种新开发的以夫妻为中心的五疗程干预），30 人被分配到常规护理 (TAU)。在怀孕 28 周、出生后 6-8 周和婴儿 6 个月大时收集结果。干预是可行和可接受的，100% 的出勤率证明了这一点。然而，在过渡到为人父母的过程中，在 TMT 或 TAU 组中没有发现关系质量或父母间不和的变化。与 TAU 相比，干预并未改善结果。通过医院焦虑和抑郁量表评估的抑郁症在整个队列中有所增加，而通过爱丁堡产后抑郁量表评估的情绪症状在母亲而非父亲中有所减少。关系质量没有下降可能反映了样本属性：夫妇比英国初为人父母的平均年龄大，受教育程度高，不和谐。即使在这个低风险样本中，30 对 TAU 夫妇中也只有 20 对完成了所有三项评估，而 30 对 TMT 夫妇中有 29 对完成了所有这三项评估。以围产期夫妇为中心的社会心理干预的更大规模随机对照试验可能会受到选择效应和自然减员的阻碍。他们可能受益于与利益相关者的共同设计和主动控制条件。

试用注册：ISRCTN12258825；2020 年 5 月 1 日（追溯注册）。