Personalized coaching reduces perinatal anxiety and depression

Personalized coaching reduces perinatal anxiety and depression | Image Credit: © Jeff Bergen/peopleimages.com - © Jeff Bergen/peopleimages.com - stock.adobe.com.

The inclusion of personal coaching (PC) sessions in electronic mindfulness-based interventions (eMBI) reduces birth-related anxiety and depressive symptoms among at-risk pregnant women, according to a recent study published in the Journal of Medical Internet Research.¹

Ten percent to 25% of pregnant women are impacted by prenatal depression, and up to 1 in 3 experience postpartum depression or anxiety.² Adverse outcomes linked to perinatal mental disorders include sleep disturbances, pregnancy complications, high-risk behavior, suicidal tendencies, and poor maternal health-related quality of life.¹

“Digital interventions such as mindfulness approaches have proven to be helpful in supporting pregnant women with mental health symptoms and in preventing excessive weight gain,” wrote investigators. “We recently demonstrated the beneficial effects of an [eMBI] in a randomized controlled clinical trial (RCT).”

In the trial, depressive and anxiety symptoms were not significantly reduced during the intervention. Therefore, investigators conducted an expansion of the previous RCT to determine the impact of PC on the mental health of pregnant women.

Participants included patients of the university hospitals of Heidelberg and Tübingen, alongside more than 200 gynecological practices in Baden-Wuerttemberg, Germany. Women were screened using the Edinburgh Postnatal Depression Scale (EPDS), with an 8-week eMBI received from 29- to 36-weeks’ gestation among those with a score over 9.

Patients were randomized 1:1 to receive either eMBI access or standard care, considered the intervention group (IG) and control group (CG), respectively. Those receiving the eMBI underwent 8 weekly 45-minute sessions starting at 29-weeks’ gestation. Obstetrical and psychoeducational content was provided alongside pregnancy-adapted mindfulness exercises during these sessions.

Digital questionnaires were administered every 2 weeks during the intervention and at 1 and 5 months postpartum. Sociodemographic and medical data, physiological measure, and self-reported maternal mental health data was collected from these questionnaires.

The 10-item EPDS was used to evaluate peripartum depression symptoms, while perinatal anxiety was assessed using the State-Trait Anxiety Inventory (STAI). The STAI includes a state scale (STAI-S) assessing anxiety as a temporary condition and a trait scale (STAI-T) assessing dispositional anxiety over time.

Pregnancy and childbirth anxiety was assessed with the Pregnancy-Related Anxiety Questionnaire–Revised (PRAQ-R), a 10-item self-report measure including fear of childbirth, concerns about bearing a physically or mentally handicapped child, and concern about one’s appearance.

Mindfulness based on the Freiburg Mindfulness Inventory (FFA-14) and body mass index (BMI) outcomes were also reported. Additionally, the Patient Health Questionnaire (PHQ-D) was utilized to assess mental disorders in primary care.

The IG had significantly reduced PHQ stress scores, more children at home, and a reduced education level vs the CG. However, differences were not reported based on PC or no PC.

PHQ stress evaluations were linked to every outcome at every measurement point except for BMI, while education level was linked to EPDS, STAI-S, STAI-T, and BMI. For the number of children, associations were found with FFA-14, PRAQ-R, STAI-S, and STAI-T. These variables were controlled as covariates in the respective analyses.

A single coaching session was provided to 137 women in the CG and 102 in the IG, while 37 and 40, respectively, received at least 2. Significant increases in mindfulness scores were reported in the IG regardless of coaching frequency (η²=0.024, ω²=0.012).

Participants receiving 2 or more coaching sessions reported significantly reduced anxiety (η²=0.0180, ω²=0.100) and depression (η²=0.020, ω²=0.009). IG patients with at least 2 sessions also often presented with a reduced BMI vs those in the CG (η²=0.036, ω²=0.013). This data indicated prenatal PC with eMBI may improve mental health in pregnant women.

“This intervention is a low-cost, easy-to-use intervention for pregnant women to improve their well-being and mental health,” wrote investigators. “However, especially in light of the ongoing digitalization in medical care, it is essential to investigate the potential of individualized, personalized care in everyday clinical practice.”

References

1. Hassdenteufel K, Müller M, Abele H. Improving maternal mental health and weight control with a mindfulness blended care approach: Insights from a randomized controlled trial. J Med Internet Res. 2025;27:e56230. doi:10.2196/56230
2. Leach LS, Poyser C, Fairweather‐schmidt K. Maternal perinatal anxiety: a review of prevalence and correlates. Clinical Psychologist. 2020;21(1):4-19. doi:10.1111/cp.12058