Effectiveness of Online Mindfulness-Based Intervention on Depression in Pregnancy
Keywords:Online, Mindfulness, Depression, Pregnancy
The high prevalence of depression in developed and developing countries requires a relevant intervention to suppress its incidence. Mindfulness-based intervention is given online as a new complementary intervention that can help reduce symptoms of depression. This study aimed to determine the effectiveness of online mindfulness-based interventions in reducing depressive symptoms in pregnancy. This research method used a randomized control trial, with 66 participants consisting of the mindfulness-based Intervention (MBI) group of 33 participants and the control group of 33 participants. The MBI intervention was provided for eight weeks online. The study uses simple random sampling. Depression was assessed using DASS 42. Data were tested using the Mann-Whitney U Test and t-test and processed with SPSS version 23. The results showed that there was a significant decrease in depression levels in the online MBI group after being given intervention compared to the control group (7.55 ± 2.181 vs 11.00 ± 2.345) p=0.000. Mindfulness-based intervention online can reduce depressive symptoms in pregnant women, so that the intervention becomes a feasible, cheap and easy intervention for pregnant women in improving mental health. In the future, this research can develop other types of complementary interventions to improve maternal and fetal health.
ACOG Committee. (2018). ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstetrics and gynecology, 132(5), e208–e212. https://doi.org/10.1097/AOG.0000000000002927
Avalos, L. A., Aghaee, S., Kurtovich, E., Quesenberry Jr, C., Nkemere, L., McGinnis, M. K., & Kubo, A. (2020). A mobile health mindfulness intervention for women with moderate to moderately severe postpartum depressive symptoms: feasibility study. JMIR mental health, 7(11), e17405. https://doi.org/10.2196/17405
Baer, R., Crane, C., Miller, E., & Kuyken, W. (2019). Doing no harm in mindfulness-based programs: conceptual issues and empirical findings. Clinical psychology review, 71, 101-114. https://doi.org/10.1016/j.cpr.2019.01.001
Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C. M. (2016). Identifying the women at risk of antenatal anxiety and depression: a systematic review. Journal of affective disorders, 191, 62-77. https://doi.org/10.1016/j.jad.2015.11.014
Cai, Y., Shen, Z., Zhou, B., Zheng, X., Li, Y., Liu, Y., ... & Chen, H. (2022). Psychological Status During the Second Pregnancy and Its Influencing Factors. Patient preference and adherence, 2355-2363. https://doi.org/10.2147/PPA.S374628
Cheng, C. Y., Chou, Y. H., Chang, C. H., & Liou, S. R. (2021). Trends of perinatal stress, anxiety, and depression and their prediction on postpartum depression. International journal of environmental research and public health, 18(17), 9307. https://doi.org/10.3390/ijerph18179307
Choi, K. W., Zheutlin, A. B., Karlson, R. A., Wang, M. J., Dunn, E. C., Stein, M. B., ... & Smoller, J. W. (2020). Physical activity offsets genetic risk for incident depression assessed via electronic health records in a biobank cohort study. Depression and anxiety, 37(2), 106-114. https://doi.org/10.1002/da.22967
Clapp, M. A., Little, S. E., Zheng, J., & Robinson, J. N. (2016). A multi-state analysis of postpartum readmissions in the United States. American journal of obstetrics and gynecology, 215(1), 113-e1. https://doi.org/10.1016/j.ajog.2016.01.174
Dadi, A. F., Miller, E. R., Bisetegn, T. A., & Mwanri, L. (2020). Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review. BMC public health, 20, 1-16. https://doi.org/10.1186/s12889-020-8293-9
Dhillon, A., Sparkes, E., & Duarte, R. V. (2017). Mindfulness-based interventions during pregnancy: A systematic review and meta-analysis. Mindfulness, 8, 1421-1437. https://doi.org/10.1007/s12671-017-0726-x
Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. P., & Beck, A. (2015). An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence. Archives of women's mental health, 18, 85-94. https://doi.org/10.1007/s00737-014-0468-x
Ding, X. X., Wu, Y. L., Xu, S. J., Zhu, R. P., Jia, X. M., Zhang, S. F., ... & Tao, F. B. (2014). Maternal anxiety during pregnancy and adverse birth outcomes: a systematic review and meta-analysis of prospective cohort studies. Journal of affective disorders, 159, 103-110. https://doi.org/10.1016/j.jad.2014.02.027
Dowse, E., Chan, S., Ebert, L., Wynne, O., Thomas, S., Jones, D., ... & Oldmeadow, C. (2020). Impact of perinatal depression and anxiety on birth outcomes: a retrospective data analysis. Maternal and child health journal, 24, 718-726. https://doi.org/10.1007/s10995-020-02906-6
Duncan, L. G., Cohn, M. A., Chao, M. T., Cook, J. G., Riccobono, J., & Bardacke, N. (2017). Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC pregnancy and childbirth, 17(1), 1-11. https://doi.org/10.1186/s12884-017-1319-3
Felder, J. N., Roubinov, D., Bush, N. R., Coleman‐Phox, K., Vieten, C., Laraia, B., ... & Epel, E. (2018). Effect of prenatal mindfulness training on depressive symptom severity through 18‐months postpartum: A latent profile analysis. Journal of Clinical Psychology, 74(7), 1117-1125. https://doi.org/10.1002/jclp.22592
Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness interventions delivered by technology without facilitator involvement: what research exists and what are the clinical outcomes?. Mindfulness, 7, 1011-1023. https://doi.org/10.1007/s12671-016-0548-2
Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2018). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical psychology review, 59, 52-60. https://doi.org/10.1016/j.cpr.2017.10.011
Goodman, J. H., Guarino, A., Chenausky, K., Klein, L., Prager, J., Petersen, R., ... & Freeman, M. (2014). CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Archives of women's mental health, 17, 373-387. https://doi.org/10.1007/s00737-013-0402-7
Grigoriadis, S., Graves, L., Peer, M., Mamisashvili, L., Tomlinson, G., Vigod, S. N., ... & Richter, M. (2018). Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: systematic review and meta-analysis. The Journal of clinical psychiatry, 79(5), 813. https://doi.org/10.4088/JCP.17r12011
Hahn-Holbrook, J., Cornwell-Hinrichs, T., & Anaya, I. (2018). Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Frontiers in psychiatry, 8, 248. https://doi.org/10.3389/fpsyt.2017.00248
Hall, H. G., Beattie, J., Lau, R., East, C., & Biro, M. A. (2016). Mindfulness and perinatal mental health: A systematic review. Women and Birth, 29(1), 62-71. https://doi.org/10.1016/j.wombi.2015.08.006
Hu, R., Li, Y., Zhang, Z., & Yan, W. (2015). Antenatal depressive symptoms and the risk of preeclampsia or operative deliveries: a meta-analysis. PloS one, 10(3), e0119018. https://doi.org/10.1371/journal.pone.0119018
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Briggs, A. M. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789-1858. https://doi.org/10.1016/S0140-6736(18)32279-7
Jarde, A., Morais, M., Kingston, D., Giallo, R., MacQueen, G. M., Giglia, L., ... & McDonald, S. D. (2016). Neonatal outcomes in women with untreated antenatal depression compared with women without depression: a systematic review and meta-analysis. JAMA psychiatry, 73(8), 826-837.
Kantrowitz-Gordon, I., McCurry, S. M., Landis, C. A., Lee, R., & Wi, D. (2020). Online prenatal trial in mindfulness sleep management (OPTIMISM): protocol for a pilot randomized controlled trial. Pilot and Feasibility Studies, 6, 1-10. https://doi.org/10.1186/s40814-020-00675-1
Krusche, A., Dymond, M., Murphy, S. E., & Crane, C. (2018). Mindfulness for pregnancy: a randomised controlled study of online mindfulness during pregnancy. Midwifery, 65, 51-57. https://doi.org/10.1016/j.midw.2018.07.005
Krusche, A., Crane, C., & Dymond, M. (2019). An investigation of dispositional mindfulness and mood during pregnancy. BMC Pregnancy and Childbirth, 19, 1-8. https://doi.org/10.1186/s12884-019-2416-2
Kuehner, C. (2017). Why is depression more common among women than among men?. The Lancet Psychiatry, 4(2), 146-158. https://doi.org/10.1016/S2215-0366(16)30263-2
Labaka, A., Goñi-Balentziaga, O., Lebeña, A., & Pérez-Tejada, J. (2018). Biological sex differences in depression: a systematic review. Biological research for nursing, 20(4), 383-392. https://doi.org/10.1177/1099800418776082
Lee, H., Kim, K. E., Kim, M. Y., Park, C. G., Han, J. Y., & Choi, E. J. (2021). Trajectories of depressive symptoms and anxiety during pregnancy and associations with pregnancy stress. International journal of environmental research and public health, 18(5), 2733. https://doi.org/10.3390/ijerph18052733
Li, X., Gao, R., Dai, X., Liu, H., Zhang, J., Liu, X., ... & Xia, W. (2020). The association between symptoms of depression during pregnancy and low birth weight: a prospective study. BMC pregnancy and childbirth, 20, 1-7. https://doi.org/10.1186/s12884-020-2842-1
Liddle, S. D., & Pennick, V. (2015). Interventions for preventing and treating low‐back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD001139.pub4
Lim, G. Y., Tam, W. W., Lu, Y., Ho, C. S., Zhang, M. W., & Ho, R. C. (2018). Prevalence of depression in the community from 30 countries between 1994 and 2014. Scientific reports, 8(1), 2861. https://doi.org/10.1038/s41598-018-21243-x
Maloni, J. A., Przeworski, A., & Damato, E. G. (2013). Web recruitment and internet use and preferences reported by women with postpartum depression after pregnancy complications. Archives of psychiatric nursing, 27(2), 90-95. https://doi.org/10.1016/j.apnu.2012.12.001
Marchesi, C., Ossola, P., Amerio, A., Daniel, B. D., Tonna, M., & De Panfilis, C. (2016). Clinical management of perinatal anxiety disorders: A systematic review. Journal of Affective Disorders, 190, 543-550. https://doi.org/10.1016/j.jad.2015.11.004
Mendelson, T., McAfee, C., Damian, A. J., Brar, A., Donohue, P., & Sibinga, E. (2018). A mindfulness intervention to reduce maternal distress in neonatal intensive care: a mixed methods pilot study. Archives of women's mental health, 21, 791-799. https://doi.org/10.1007/s00737-018-0862-x
Miklowitz, D. J., Semple, R. J., Hauser, M., Elkun, D., Weintraub, M. J., & Dimidjian, S. (2015). Mindfulness-based cognitive therapy for perinatal women with depression or bipolar spectrum disorder. Cognitive Therapy and Research, 39, 590-600. https://doi.org/10.1007/s10608-015-9681-9
Miller, E. S., Saade, G. R., Simhan, H. N., Monk, C., Haas, D. M., Silver, R. M., ... & Grobman, W. A. (2022). Trajectories of antenatal depression and adverse pregnancy outcomes. American journal of obstetrics and gynecology, 226(1), 108-e1. https://doi.org/10.1016/j.ajog.2021.07.007
Moore, D., Ayers, S., & Drey, N. (2016). A thematic analysis of stigma and disclosure for perinatal depression on an online forum. JMIR mental health, 3(2), e5611. https://doi.org/10.2196/mental.5611
Nasrollahi, M., Ghazanfar Pour, M., Ahmadi, A., Mirzaee, M., & Alidousti, K. (2022). Effectiveness of mindfulness-based stress reduction on depression, anxiety, and stress of women with the early loss of pregnancy in southeast Iran: a randomized control trial. Reproductive Health, 19(1), 1-9. https://doi.org/10.1186/s12978-022-01543-2
Nejad, F. K., Shahraki, K. A., Nejad, P. S., Moghaddam, N. K., Jahani, Y., & Divsalar, P. (2021). The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial. Journal of Preventive Medicine and Hygiene, 62(1), E82–E88. https://doi.org/10.15167/2421-4248/jpmh2021.62.1.1691
Nisar, A., Yin, J., Waqas, A., Bai, X., Wang, D., Rahman, A., & Li, X. (2020). Prevalence of perinatal depression and its determinants in Mainland China: A systematic review and meta-analysis. Journal of Affective Disorders, 277, 1022-1037. https://doi.org/10.1016/j.jad.2020.07.046
Nyklíček, I., Truijens, S. E., Spek, V., & Pop, V. J. (2018). Mindfulness skills during pregnancy: prospective associations with mother's mood and neonatal birth weight. Journal of psychosomatic research, 107, 14-19. https://doi.org/10.1016/j.jpsychores.2018.01.012
O'Connor, R. C., Wetherall, K., Cleare, S., McClelland, H., Melson, A. J., Niedzwiedz, C. L., ... & Robb, K. A. (2021). Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. The British journal of psychiatry, 218(6), 326-333.
Pereira, P. K., Lovisi, G. M., Lima, L. A., Legay, L. F., de Cintra Santos, J. F., Santos, S. A., ... & Valencia, E. (2011). Depression during pregnancy: review of epidemiological and clinical aspects in developed and developing countries. Psychiatric Disorders-Trends and Developments, 10, 267-290.
Rogers, A., Obst, S., Teague, S. J., Rossen, L., Spry, E. A., Macdonald, J. A., ... & Hutchinson, D. (2020). Association between maternal perinatal depression and anxiety and child and adolescent development: a meta-analysis. JAMA pediatrics, 174(11), 1082-1092. https://doi.org/10.1001/jamapediatrics.2020.2910
Schumer, M. C., Lindsay, E. K., & Creswell, J. D. (2018). Brief mindfulness training for negative affectivity: A systematic review and meta-analysis. Journal of consulting and clinical psychology, 86(7), 569. https://doi.org/10.1037/ccp0000324
Schiele, C., Goetz, M., Hassdenteufel, K., Müller, M., Graf, J., Zipfel, S., & Wallwiener, S. (2022). Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study. Frontiers in Psychiatry, 13, 939577. https://doi.org/10.3389/fpsyt.2022.939577
Spijkerman, M. P. J., Pots, W. T. M., & Bohlmeijer, E. (2016). Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical psychology review, 45, 102-114. https://doi.org/10.1016/j.cpr.2016.03.009
Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., ... & Pariante, C. M. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819. https://doi.org/10.1016/S0140-6736(14)61277-0
Szegda, K., Markenson, G., Bertone-Johnson, E. R., & Chasan-Taber, L. (2014). Depression during pregnancy: a risk factor for adverse neonatal outcomes? A critical review of the literature. The Journal of Maternal-Fetal & Neonatal Medicine, 27(9), 960-967. https://doi.org/10.3109/14767058.2013.845157
Taylor, B. L., Cavanagh, K., & Strauss, C. (2016). The effectiveness of mindfulness-based interventions in the perinatal period: a systematic review and meta-analysis. PloS one, 11(5), e0155720. https://doi.org/10.1371/journal.pone.0155720
Toscano, M., Royzer, R., Castillo, D., Li, D., & Poleshuck, E. (2021). Prevalence of depression or anxiety during antepartum hospitalizations for obstetric complications: A systematic review and meta-analysis. Obstetrics and gynecology, 137(5), 881. https://doi.org/10.1097/AOG.0000000000004335
Tsakiridis, I., Bousi, V., Dagklis, T., Sardeli, C., Nikolopoulou, V., & Papazisis, G. (2019). Epidemiology of antenatal depression among women with high-risk pregnancies due to obstetric complications: a scoping review. Archives of gynecology and obstetrics, 300, 849-859. https://doi.org/10.1007/s00404-019-05270-1
Turner, J. A., Anderson, M. L., Balderson, B. H., Cook, A. J., Sherman, K. J., & Cherkin, D. C. (2016). Mindfulness-based stress reduction and cognitive-behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial. Pain, 157(11), 2434. https://doi.org/10.1097/j.pain.0000000000000635
Van Ravesteyn, L. M., Lambregtse-van den Berg, M. P., Hoogendijk, W. J., & Kamperman, A. M. (2017). Interventions to treat mental disorders during pregnancy: a systematic review and multiple treatment meta-analysis. PLoS One, 12(3), e0173397. https://doi.org/10.1371/journal.pone.0173397
Vignato, J., Perkhounkova, Y., McCarthy, A. M., & Segre, L. S. (2020). Pain and depression symptoms during the third trimester of pregnancy. MCN: The American Journal of Maternal/Child Nursing, 45(6), 351-356. https://doi.org/10.1097/NMC.0000000000000657
Ward, K., Herekar, A., Wang, P., & Lindsay, K. L. (2023). Feasibility and Acceptability of a Mindfulness-Based Smartphone App among Pregnant Women with Obesity. International Journal of Environmental Research and Public Health, 20(7), 5421. https://doi.org/10.3390/ijerph20075421
Woolhouse, H., Mercuri, K., Judd, F., & Brown, S. J. (2014). Antenatal mindfulness intervention to reduce depression, anxiety and stress: a pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC pregnancy and childbirth, 14(1), 1-16. https://doi.org/10.1186/s12884-014-0369-z
Yazdanimehr, R., Omidi, A., Sadat, Z., & Akbari, H. (2016). The effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women: a randomized clinical trial. Journal of caring sciences, 5(3), 195. https://doi.org/10.15171/jcs.2016.021
Zhang, L., Wang, L., Cui, S., Yuan, Q., Huang, C., & Zhou, X. (2021). Prenatal depression in women in the third trimester: Prevalence, predictive factors, and relationship with maternal-fetal attachment. Frontiers in Public Health, 8, 602005. https://doi.org/10.3389/fpubh.2020.602005
Zietlow, A. L., Schlüter, M. K., Nonnenmacher, N., Müller, M., & Reck, C. (2014). Maternal self-confidence postpartum and at pre-school age: the role of depression, anxiety disorders, maternal attachment insecurity. Maternal and Child Health Journal, 18, 1873-1880. https://doi.org/10.1007/s10995-014-1431-1
Zohsel, K., Holz, N. E., Hohm, E., Schmidt, M. H., Esser, G., Brandeis, D., ... & Laucht, M. (2017). Fewer self-reported depressive symptoms in young adults exposed to maternal depressed mood during pregnancy. Journal of affective disorders, 209, 155-162. https://doi.org/10.1016/j.jad.2016.08.059
How to Cite
Copyright (c) 2023 JURNAL INFO KESEHATAN
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Ownership of copyright
The copyright in this website and the material on this website (including without limitation the text, computer code, artwork, photographs, images, music, audio material, video material and audio-visual material on this website) is owned by JURNAL INFO KESEHATAN and its licensors.
JURNAL INFO KESEHATAN grants to you a worldwide non-exclusive royalty-free revocable license to:
- view this website and the material on this website on a computer or mobile device via a web browser;
- copy and store this website and the material on this website in your web browser cache memory; and
- print pages from this website for your use.
- All articles published by JURNAL INFO KESEHATAN are licensed under the Creative Commons Attribution 4.0 International License. This permits anyone to copy, redistribute, remix, transmit and adapt the work provided the original work and source is appropriately cited.
JURNAL INFO KESEHATAN does not grant you any other rights in relation to this website or the material on this website. In other words, all other rights are reserved.
For the avoidance of doubt, you must not adapt, edit, change, transform, publish, republish, distribute, redistribute, broadcast, rebroadcast or show or play in public this website or the material on this website (in any form or media) without appropriately and conspicuously citing the original work and source or JURNAL INFO KESEHATAN prior written permission.
You may request permission to use the copyright materials on this website by writing to email@example.com.
Enforcement of copyright
JURNAL INFO KESEHATAN takes the protection of its copyright very seriously.
If JURNAL INFO KESEHATAN discovers that you have used its copyright materials in contravention of the license above, JURNAL INFO KESEHATAN may bring legal proceedings against you seeking monetary damages and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of JURNAL INFO KESEHATAN copyright materials that contravenes or may contravene the license above, please report this by email to firstname.lastname@example.org
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to email@example.com.