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Effectiveness of a Mindfulness-based Mobile Intervention for Perinatal Mental Health on Depression During Pregnancy: Randomized Controlled Trial (Preprint)

Minjung Kim, Jin Young Park, Sehwan Park, Kyungmi Chung, Hee Young Cho, Gangho Do, Kyungun Jhung

DOI: 10.2196/preprints.75630 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial
Sample size 86
Population Pregnant women recruited online and offline
Topics Depression Meditation
Key findings The authors report that pregnant women who used the Avecmom mindfulness app alongside self-monitoring showed lower depression scores and better mindfulness, maternal-fetal attachment, mental well-being, and positive affect than those who used self-monitoring alone. Serial mediation suggested mindfulness gains led to reduced depressive symptoms and improved mental well-being (standardized beta=.33, 95% BootCI 0.12-0.58).

Abstract

Background: Pregnancy is a vulnerable period for women, exposing them to various mental health issues such as depression and anxiety. The perinatal period is particularly crucial because the mother's mental health significantly affects the mother’s physical health, pregnancy outcomes, fetal development, postnatal outcomes, and infant development. Psychotherapeutic approaches for depression are vital because medication use is limited during pregnancy. However, perinatal women with depression often face barriers in accessing psychotherapeutic interventions. Digital health may offer a solution for overcoming these barriers.

Objective: In this study, we evaluated the effectiveness of Avecmom, a self-guided mindfulness-based mobile intervention, in reducing depression among pregnant women. We also evaluated the impact of the mobile app on positive/negative emotions, mental well-being, and maternal-fetal attachment.

Methods: Participants were recruited online and offline. After screening, 90 out of 158 participants met the study criteria and were randomly assigned to either the intervention or the control group. The intervention group used both apps, whereas the control group used only the Big 4+ app. Depressive symptoms, anxiety, and stress were evaluated as the primary outcomes at baseline and posttest. Mindfulness, mental well-being, positive/negative emotions, and maternal-fetal attachment were also assessed as secondary outcomes. Analysis of covariance (ANCOVA) was performed with post-test scores as the dependent variable, adjusting for baseline scores. The bootstrapping technique from PROCESS Model 6 was applied to estimate the mechanism of change after using the Avecmom mobile app.

Results: A total of 86 pregnant women were included in the intervention group (n=42; age: mean 34.10, SD 3.04) and the control group (n=44, age: mean 33.80, SD 3.42). The overall dropout rate was 4% (4/90). The intervention group showed lower depression scores, mindfulness, maternal-fetal attachment, mental well-being, and positive affect compared to the control group. Serial mediation analysis indicated that use of the Avecmom app influenced mental well-being through sequential improvements in mindfulness and decreases in depressive symptoms (standardized β=.33, BootSE=0.12, 95% BootCI[0.12; 0.58]).

Conclusions: Mindfulness-based mobile interventions designed for pregnant women may be more effective than self-monitoring alone in improving perinatal depression. Enhanced mindfulness through the use of a mobile app seems to lead to a decrease in depressive symptoms and, consequently, improved mental well-being. CLINICALTRIAL KCT0008887.

Comparable studies

Other randomized controlled trials on depression, most cited first.

Study Year Design Participants
A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Subjects with DSM-IV major depression (treatment resistant) 2006 Randomized, placebo-controlled, double-blind crossover study n = 18
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety 2016 Randomized controlled trial n = 51
Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Patients with cancer-related anxiety and depression 2016 Double-blind, placebo-controlled, crossover trial n = 29
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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