JMIR Publications

ABSTRACT

Background:

Maternal psychological distress during pregnancy is prevalent and has been associated with unfavorable outcomes in infants, and Mindfulness - based interventions (MBIs) can effectively alleviate maternal psychological distress, but there are often barriers to accessing face - to - face interventions. Indeed, the prevalence of psychological distress in expectant fathers is comparable to that in expectant mothers; moreover, paternal distress affects maternal mental health and the subsequent parent - child relationship. However, research on paternal psychological distress during pregnancy, especially the impact of such distress on offspring, remains scarce; even fewer studies target expectant parents as a unit exposed to child - bearing - related stressors for research and intervention.

Objective:

This study aimed to investigate the effectiveness of a digital Mindfulness-Based Intervention for Expectant Parents (dMBI-EP) in reducing parental psychological distress and improving infant neuropsychological performance.

Methods:

This randomized controlled trial recruited 160 couples expecting their first child, with the pregnant women at 12 - 20 weeks of gestation. They were randomized into a dMBI-EP group receiving regular prenatal care plus a 6 - week intervention via a WeChat mini - program and a control group receiving regular perinatal care only. Primary outcomes were parental psychological distress (depression, anxiety, perceived stress symptoms) assessed at baseline (T1), 2 weeks post - intervention (T2), and 6 weeks postpartum (T3). Secondary outcomes included other parental biopsychosocial stress responses (fatigue, sleep problems, marital intimacy, parental - fetal bonding) assessed at T1 and T2, and infant neuropsychological outcomes (including temperament and developmental behaviors) assessed at T3.

Results:

For expectant mothers, results show a significant time × group interaction for symptoms of depression (Wald χ² = 10.133; q = 0.002) and perceived stress (Wald χ² = 18.636; q < 0.001). In the intervention group, depression and perceived stress symptoms at T2 were significantly lower than in the control group, with Cohen's d values of 0.49 and 0.67 respectively. However, for anxiety symptoms, there's an insignificant time × group interaction (Wald χ² = 2.543; q = 0.111). For expectant fathers, the results indicate a significant time × group interaction for depression symptoms (Wald χ² = 9.593; q = 0.006). In the intervention group, depression at T2 were significantly lower than those in the control group, with Cohen's d = 0.38. However, an insignificant time × group interaction for symptoms of anxiety (Wald χ² = 0.653; q = 0.419) and perceived stress (Wald χ² = 1.829; q = 0.264) was found. In addition, the average scores of the infants' activity level (t = 3.845, q < 0.001), approach (t = 2.330, q = 0.049), intensity of reaction (t = 3.398, q = 0.004), quality of mood (t = 5.124, q < 0.001), distractibility (t = 4.087, q < 0.001), and adaptability (t = 3.138, q = 0.006) in the control group at 6 weeks postpartum were significantly higher than those in the intervention group statistically.

Conclusions:

Digital Mindfulness-Based Intervention for Expectant Parents (dMBI-EP) are effective in alleviating psychological distress among expectant parents and protecting their infant outcomes. Clinical Trial: Chinese Clinical Trial Register ChiCTR2200059598