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Title: Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial.
Austin Authors: Milgrom, Jeannette ;Hirshler, Yafit;Holt, Charlene ;Skouteris, Helen;Galbally, Megan;East, Christine;Glover, Vivette;Reece, John;O'Donnell, Kieran J;Walker, Susan P;Malloy, Shannon;Gemmill, Alan W 
Affiliation: Parent-Infant Research Institute
Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Health Futures Institute, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia.;School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia.;Mental Health, Program Monash Medical Centre, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.
Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Drive, Bundoora, VIC, 3086, Australia.;Mercy Hospital for Women, 163 Studley Road, Heidelberg, VIC, 3084, Australia.
Institute of Reproductive and Developmental Biology, Imperial College London, Du Cane Road, London, W12 ONN, UK.
School of Psychological Sciences, Australian College of Applied Professions, 123 Lonsdale Street, Melbourne, VIC, 3000, Australia.
Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT, 06519, USA.;Department of Obstetrics Gynecology and Reproductive Sciences, 230 South Frontage Road, New Haven, CT, 06519, USA.;Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
Mercy Hospital for Women, 163 Studley Road, Heidelberg, VIC, 3084, Australia.;Melbourne Medical School, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia.
Ovia Health, 263 Summer Street, Boston, MA, 02210, USA.
Issue Date: 4-Aug-2023
Date: 2023
Publication information: BMC Psychology 2023-08-04; 11(1)
Abstract: Substantial evidence indicates that maternal depression during pregnancy (i.e., antenatal depression) is associated not only with maternal wellbeing but also with child emotional and behavioural development. Children of antenatally depressed women are at risk of emotional and behavioural problems, including internalising problems (e.g., anxiety and depression) and externalising problems (e.g., attention problems), that may last at least to adolescence. These enduring effects also constitute an enormous economic cost. Despite the seriousness of this problem, until recently there existed very few controlled studies evaluating whether active psychological treatment for antenatal depression can prevent adverse child outcomes. Our previous pilot randomised controlled trial (RCT) exploring the effect of cognitive behavioural therapy (CBT) for antenatal depression on child outcomes showed promising results. We aim to assess whether treating antenatal depression with an evidence-based 8-week structured CBT program can prevent or ameliorate adverse child developmental outcomes at 2 years of age. Pregnant women ≤ 30 weeks gestation diagnosed with a depressive disorder are recruited and randomised to CBT or treatment as usual (TAU). The target sample size is 230 and the primary outcome measure is the infant Internalising scale of the Child Behaviour Checklist (CBCL) at 24 months of age. Secondary infant outcome measures at 24 months are the Externalising scale of the CBCL and the motor and cognitive development subscales of the Ages & Stages Questionnaire (ASQ-3). Additional secondary outcome measures are subscales of the Revised Infant Behaviour Questionnaire (IBQ-R), ASQ-3 and the ASQ-Socio-Emotional (ASQ-SE) at 3 and 12 months of age and the quality of mother-infant interaction at 3 and 24 months. Maternal measures, including demographic data, depression diagnosis, depressive and anxiety symptoms, perceived stress and parenting stress, are collected across all time points. The trial is ongoing and recruitment was slowed due to the COVID-19 pandemic. If results suggest a beneficial effect of antenatal depression treatment on infant outcomes, the project could have repercussions for standard antenatal care, for maternal and infant health services and for preventing the intergenerational transmission of mental health disorders. Australia and New Zealand Clinical Trials Register: ACTRN12618001925235 Date Registered: 27 November 2018.
DOI: 10.1186/s40359-023-01244-w
Journal: BMC Psychology
Start page: 222
PubMed URL: 37542332
ISSN: 2050-7283
Type: Journal Article
Subjects: Antenatal anxiety
Antenatal depression
Child emotional and behavioural development
Child internalising behaviour
Cognitive behavioural therapy
Psychological treatment
Depression/prevention & control
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