Effects of Mindfulness-Based Cognitive Therapy in Pregnancy on Psychological Distress and Gestational Age: Outcomes of a Randomized Controlled Trial

Abstract

Given stress, anxiety, and depression affect 15–25% of women during pregnancy and are associated with adverse outcomes for maternal and child health if untreated, a randomized controlled trial evaluated the effectiveness of an 8-week modified Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) intervention for psychological distress. A community sample of pregnant women who self-identified as experiencing high levels of psychological distress was randomized into MBCT-PD (n = 28) or treatment as usual (n = 32). Participants completed online questionnaires assessing symptoms of distress, pregnancy and generalized anxiety, depression, and stress during lab visits at enrolment (before allocation), immediately following the intervention, and at follow-up (3 months postpartum). Women also reported delivery type and gestational age of their newborn. Using an intention-to-treat approach, multilevel modeling indicated a significant effect of MBCT-PD treatment on overall psychological distress, but not on other symptoms. Path analysis revealed a moderated mediation, with an indirect effect of MBCT-PD treatment on lengthening gestational age through decreasing pregnancy anxiety among women with higher baseline symptoms. In pregnant women seeking treatment for high levels of psychological distress, MBCT-PD was associated with improved overall distress, but not other specific symptoms such as anxiety and depression beyond treatment as usual. MBCT-PD has the potential to reduce the risk of preterm birth by targeting and reducing high levels of pregnancy anxiety during early gestation. Further research is warranted to examine other outcomes (e.g., coping skills, interpersonal functioning) and comparisons to other interventions.