Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial

Jeannette Milgrom; Yafit Hirshler; Charlene Holt; Helen Skouteris; Megan Galbally; Christine East; Vivette Glover; John Reece; Kieran J. O’Donnell; Susan P. Walker; Shannon Malloy; Alan W. Gemmill

doi:10.1186/s40359-023-01244-w

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Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial

Journal article

Open access

Peer reviewed

Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial

Jeannette Milgrom, Yafit Hirshler, Charlene Holt, Helen Skouteris, Megan Galbally, Christine East, Vivette Glover, John Reece, Kieran J. O’Donnell, Susan P. Walker, …

BMC Psychology, Vol.11(1), 222

2023

DOI: https://doi.org/10.1186/s40359-023-01244-w

PMID: 37542332

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Abstract

Antenatal anxiety

Antenatal depression

Child emotional and behavioural development

Child internalising behaviour

Cognitive behavioural therapy

Psychological treatment

Study Protocol

Background 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. Methods 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. Discussion 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. Trial registration Australia and New Zealand Clinical Trials Register: ACTRN12618001925235 Date Registered: 27 November 2018.

Details

Title: Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial
Authors/Creators: Jeannette Milgrom - Austin Health
Yafit Hirshler - Austin Health
Charlene Holt - Austin Health
Helen Skouteris - Monash University
Megan Galbally - Murdoch University, Centre for Computational and Systems Medicine
Christine East - La Trobe University
Vivette Glover - Imperial College London
John Reece - Australian College of Applied Psychology
Kieran J. O’Donnell - McGill University
Susan P. Walker - The University of Melbourne
Shannon Malloy - Corvia Medical (United States)
Alan W. Gemmill - Austin Health
Publication Details: BMC Psychology, Vol.11(1), 222
Publisher: BioMed Central
Grant note: ; APP1143448; APP1143448; APP1143448; APP1143448; APP1143448; APP1143448; APP1143448; APP1143448 / ;
Identifiers: 991005599070207891
Murdoch Affiliation: Health Futures Institute
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.72 Obstetrics & Gynecology; 1.72.1072 Perinatal Mental Health
Web Of Science research areas: Psychology, Multidisciplinary
ESI research areas: Psychiatry/Psychology