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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 1/2016

01-01-2016

Preventive Effects on Birth Outcomes: Buffering Impact of Maternal Stress, Depression, and Anxiety

Authors: Mark E. Feinberg, Damon E. Jones, Michael E. Roettger, Michelle L. Hostetler, Kari-Lyn Sakuma, Ian M. Paul, Deborah B. Ehrenthal

Published in: Maternal and Child Health Journal | Issue 1/2016

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Abstract

Objective

Although maternal stress, anxiety, and depression have been linked to negative birth outcomes, few studies have investigated preventive interventions targeting maternal mental health as a means of reducing such problems. This randomized controlled study examines whether Family Foundations (FF)—a transition to parenthood program for couples focused on promoting coparenting quality, with previously documented impact on maternal stress, depression, and anxiety—can buffer the negative effects of maternal mental health problems.

Methods

To assess the effects of FF, we used a randomized block design with a sample of 259 expectant mothers assigned to FF or a control condition and analyzed using propensity score models. We examine two-way interactions of condition (intervention vs. control) with maternal mental health problems (financial stress, depression, and anxiety) on birth outcomes (birth weight, days in hospital for mothers and infants). For birth weight, we assess whether intervention effects depend on length of gestation by including a third interaction term.

Results

FF buffered (p < 0.05) the negative impact of maternal mental health problems on birth weight and both mother and infant length of post-partum hospital stay. For birth weight, assignment to FF was associated with higher birth weight for infants born before term.

Conclusions

These results demonstrate that a psycho-educational program for couples focused on enhancing mutual coparental support, with preventive effects on maternal mental health, can reduce incidence of birth problems among women at elevated risk. Such improvements in birth outcomes could translate into substantial reductions in public and personal healthcare costs. Future work should assess mediating mechanisms of intervention impact and cost-benefit ratio of the intervention.

Clinical trials registration

The Family Foundations follow-up intervention study is currently registered with www.​clinicaltrials.​gov. The study identifier is NCT01907412.
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Metadata
Title
Preventive Effects on Birth Outcomes: Buffering Impact of Maternal Stress, Depression, and Anxiety
Authors
Mark E. Feinberg
Damon E. Jones
Michael E. Roettger
Michelle L. Hostetler
Kari-Lyn Sakuma
Ian M. Paul
Deborah B. Ehrenthal
Publication date
01-01-2016
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 1/2016
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-015-1801-3

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