Preventing postnatal depression in mothers of very preterm infants: a randomised controlled trial

Objective To test whether a cognitive-behaviour therapy intervention program reduces the prevalence of depression during the first postnatal year in mothers of very preterm babies. Design Prospective, single blind, randomised, controlled study. Setting Perinatal centre in Western Australia. Participants One hundred and ninety-nine out of 673 English-speaking mothers of infants admitted to the neonatal unit. Intervention A six-session cognitive-behaviour therapy intervention program provided by a research midwife between weeks two and six after birth. Women in the control group received standard care. Main outcome measures Depression and anxiety disorders occurring in the first year assessed by a clinical psychologist at structured interview using the Schedule for Affective Disorders and Schizophrenia (SADS) at 2 weeks, 2, 6 and 12 months. Results One hundred and one women were randomised to the intervention group and 98 to the control group. Fifty-four mothers (27%) in the trial were diagnosed with minor or major depression in the 12 months following very preterm-delivery, 29 (29%) in the intervention group and 25 (26%) in the control group (relative risk 1.1 [95% Cl 0.80-1.5]). There were no differences in the time of onset or the duration of the episodes of depression between the groups. Overall, 74 mothers (37%) of the 199 met criteria for a diagnosis of psychological morbidity during the first year. Conclusions Our intervention program did not alter the prevalence of depression in these mothers. Rates of depression and stress reactions are high in these mothers.