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Improving Maternal Mental Health and Weight Control With a Mindfulness Blended Care Approach: Insights From a Randomized Controlled Trial.

Kathrin Hassdenteufel, Mitho Müller, Harald Abele, Sara Yvonne Brucker, Johanna Graf, Stephan Zipfel, Armin Bauer, Peter Jakubowski, Jan Pauluschke-Fröhlich, Markus Wallwiener, Stephanie Wallwiener

Journal of Medical Internet Research February 24, 2025 DOI: 10.2196/56230 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 460
Population Pregnant women with a singleton pregnancy who screened positive for depression in Baden-Württemberg, Germany
Interventions electronic mindfulness-based intervention face-to-face coaching
Duration 8-week intervention between 29th and 36th gestational week
Topics Anxiety Depression Meditation
Keywords Digital intervention Effectiveness Ehealth Electronic Maternal mental health Mindfulness-based intervention Peripartum mental health Personal coaching Postpartum Pregnancy Treatment Weight gain Women
Citations 1
Key findings Adding at least two face-to-face coaching sessions to an eMBI significantly lowered depression and anxiety symptoms and reduced BMI compared to the digital intervention alone.

Abstract

Perinatal maternal mental health problems, such as depression and anxiety, are highly prevalent during pregnancy and post partum. Electronic mindfulness-based interventions (eMBIs) are a promising treatment option, which can be provided in a low-threshold, cost-effective manner. However, research underscores the fact that face-to-face coaching sessions are more effective than solely digital methods. A blended care approach (eMBI with direct face-to-face coaching) could amplify the therapeutic impact on maternal mental health and weight gain during the perinatal period. We investigated whether combining an eMBI intervention with face-to-face personal support significantly improves maternal mental health, and whether the intervention can influence weight gain in affected women during pregnancy. A community-based sample of 460 pregnant women with a singleton pregnancy who screened positive for depression was enrolled in a multicenter randomized controlled trial (RCT) including the University Hospitals of Heidelberg and Tübingen as well as more than 200 gynecological practices within the state of Baden-Württemberg in Germany between February 2019 and October 2020. Participating women were randomized 1:1 to the control group (CG) or intervention group (IG) that received access to an 8-week pregnancy-adapted eMBI between the 29th and 36th gestational week. In a subanalysis, we grouped participants in those receiving only the initial face-to-face coaching session at recruitment (no personal coaching) and those with ≥2 personal coaching sessions. Primary outcome measures were severity of depressive symptoms using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, the Pregnancy-Related Anxiety Questionnaire, the Freiburg Mindfulness Inventory, and the Patient Health Questionnaire; secondary outcome measure, BMI. In the final sample, 137 CG women and 102 IG women received only one coaching session, whereas 37 CG women and 40 IG women received at least 2 (mean 2.3, SD 0.7) coaching sessions. The analyses were adjusted for significant confounders. The IG's mindfulness scores increased significantly (F1.873,344.619=4.560, P=.01, η²=0.024, ω²=0.012) regardless of coaching frequency. Both general anxiety (F12,129=2.361, P=.01, η²=0.0180, ω²=0.100) and depression symptoms (F4.758, 699.423=3.033, P=.01, η²=0.020, ω²=0.009) were significantly lower in the group that received ≥2 coaching sessions than in the no-personal-coaching group. In the group receiving ≥2 coaching sessions, BMI generally was lower in the IG than in the CG (F3.555,444.416=4.732, P=.002, η²=0.036, ω²=0.013). Adding a minimal amount of PC to the digital eMBI increased mindfulness and decreased birth-related anxiety, symptoms of depression, and anxiety in at-risk pregnant women. Favorable effects on gestational weight gain were found in the respective IGs, the strongest effect being within the PC group. This blended digital health approach amplifies the effectiveness of the digital intervention. German Clinical Trials Register DRKS00017210; https://www.drks.de/search/de/trial/DRKS00017210.

Comparable studies

Other randomized controlled trials on meditation, most cited first.

Study Year Design Participants
Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment 2003 Randomized controlled trial n = 41
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults 2008 Randomized controlled trial n = 139
Short-term meditation training improves attention and self-regulation Undergraduate Chinese students 2007 Randomized controlled trial n = 40
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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Anxiety Depression Meditation