Biofeedback training during pregnancy decreases the risk of postpartum depression: a prospective randomized controlled trial

Abstract

Objective To explore the clinical function of biofeedback training in patients with high risks of postpartum depression,and to provide a new method to decrease the risk of postpartum depression.Methods From May 1,to December 31,2010,in Bayi Children's Hospital,General Hospital of Beijing Military Area Command of Chinese PLA,60 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) evaluation score of 6 to 12 at 12～14 gestational weeks were randomly divided into the biofeedback training group (n=30) and the control group (n=30).The control group learned prenatal care knowledge in pregnant women's school.Moreover,the biofeedback training group received Self-generate Physiological Coherence System training till one week before delivery.Both groups were evaluated with the EPDS at baseline,and 3 days,6 weeks,3 months postpartum.Differences between the two groups were compared with mixed effect model.Results Totally,there were 51 pregnant women finished the study,including 25 women in the biofeedback training group and 26 in the control group.There were no statistical difference in EPDS score at 12～14 gestational weeks between the biofeedback training group and control group [8.5±2.0 vs 8.5±1.9,t=0.03,P=0.97].At 3 days,6 weeks and 3 months postpartum,the EPDS score of biofeedback training group was 4.1 ± 1.8,4.7 ± 2.0 and 4.6 ± 1.8 respectively,which was lower than those in the control group (6.5 ± 2.4,7.0 ± 2.5and 6.9±2.4) (interaction effect F=4.35,P=0.01).On each postpartum time-point,OR value and 95％CI was 0.12 (0.03-0.45),0.21 (0.06-0.68) and 0.23 (0.07-0.77),P＜0.05 respectively.Cohen's d value were 1.17,0.99 and 1.06 respectively.Compared with the baseline value,the total EPDS scores in each study stage declined with varied degrees in both groups,and the score-reducing level were obvious in the biofeedback training group than in the control group.Conclusion Biofeedback training could effectively relieve the depression symptoms in pregnant women with high risks of postpartum depression,and decrease the risk of postpartum depression. Key words: Depression, postpartum; Biofeedback (psychology) ; Pregnancy complications; Depressive disorder; Treatment outcome