A new UC San Francisco study shows that low-cost, prenatal intervention benefits mothers’ mental health up to eight years later.
In the study, which was one of the first to look at results so far, pregnant women who attended a group health class weekly for eight weeks were half as likely to become depressed after eight years, compared to women who received standard care. According to research published in the journal Journal of Counseling and Clinical Psychology.
Previous research on the same group of women found that the intervention also reduced the risk of short-term depression and diabetes, and promoted healthier stress responses in their children.
«Given the economic and social burden of maternal depression and its potential impact on the offspring, our findings reveal a meaningful benefit of a modest investment that supports well-being over two generations during pregnancy.»
Danielle Roubinov, PhD, UCSF professor of psychiatry and first author of the study
The eight-week classroom intervention, led by UCSF psychiatry professor Elissa Epel and her team, involved groups of eight to 10 pregnant women who met for two hours a week. eating, breathing and moving. They were guided through group lessons and activities by a graduate-level health professional. The women also received two phone sessions with their babies and a postpartum «booster» group session.
Participants in the BIPOC study were prioritized
Nicki Bush, PhD, professor of pediatrics and psychiatry at the UCSF Weill Institute for Neuroscience and the study’s senior author, noted that historically, most studies on prenatal depression have primarily involved white women — but that’s not it, she said.
«Our participants were low-income, racially and ethnically diverse women who were systematically exposed to factors that put them at risk for depression, such as racism and economic hardship,» Bush said. «Also, the last years of the study were during the COVID-19 pandemic, when rates of depression were higher for all and the burden on non-white communities was even greater. Despite this, the treatment effects persisted.»
In the study, 162 women were assigned to either the intervention group or the standard care group. Women’s depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9) before wellness intervention classes, after wellness classes, and at 1, 2, 3-4, 5, 6, and 8 years.
Although both groups of women showed equal symptoms of depression before class, 12 percent of women who were part of the wellness class reported moderate or severe depressive symptoms at year eight, compared to 25 percent of women who received standard care. She was a consistent pattern throughout these years.
«Practicing mindfulness is known to help relieve stress in many situations and can significantly impact coping and health, where it appears to be particularly potent during pregnancy with lasting effects,» Bush said. Said. «Our opinion is that community connections and social support for the (health class) group are also therapeutic.»
Stress management, nutrition and exercise during pregnancy
Researchers are currently collecting additional data to better understand how the intervention has such a long-term effect. Potential mechanisms include long-term changes in coping and stress reactivity, nutrition and exercise.
About 27 percent of pregnant women suffer from prenatal depression, a precursor to postpartum depression. Maternal depression is also associated with social, emotional and cognitive deficits in offspring.
«This dramatic demonstration of both the short-term reduction of depressive symptoms and the long-term prevention of more severe maternal depression, even during the pandemic, is remarkable even for us researchers,» Epel said. “The effects of increased stress resilience in these women are likely to have far-reaching effects on their own health and their children. If Dr. Bush and his team had not followed them for eight years, we would never have known the persistence of these changes. We already know that pregnancy is a critical period, and the lesson here is to look at pregnancy health interventions. It’s a big investment we have to make.»
The researchers hope that the low-cost and relatively short-term commitment of the intervention class will facilitate scaling to larger groups of pregnant women -; especially women of color and those with lower incomes.
«It is crucial to have interventions that meet the needs of low-income, Black, Indigenous and people of color who are particularly likely to experience the stress of social inequalities,» Roubinov said. “We are excited to see how these results can be scaled up to reach more women and a more diverse pool of women.”
Stice, E & Davila, J., et al. (2022) Introduction to a special issue of the Journal of Consulting and Clinical Psychology: «Best practices» in prevention and treatment for racial and ethnic minorities. Journal of Counseling and Clinical Psychology. doi.org/10.1037/ccp0000767.
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