[Preventing the risk of postpartum depression and premature childbirth by a psychosomatic approach: a randomized multicenter study]

Abstract

Background and objective: Randomized studies to assess postnatal depression and preterm childbirth are rarely in conjunction; the 2 problems are treated separately regardless of their common risk factors. The main objective of this study was to evaluate the effects of a prenatal program based on a psychosomatic approach on the risk of postpartum depression (PPD) and preterm childbirth.

Subjects and method: Controlled clinical trial, randomized and multicenter study. A total of 184 pregnant women identified as vulnerable to PPD who had psychosocial risk factors associated with preterm childbirth were assigned to the experimental group (EG) (n=92) or control group (CG) (n=92), according to a computerized program. The EG participated in the program with a psychosomatic approach (10 sessions (one/week) for 2 h, 15 m) with a phone call between sessions; the objectives implicated the mother, father and baby contemplating pregnancy, childbirth and postpartum. Women in the EC made the usual program of the health center (8-10 weekly sessions of 2 hours), with no calls, with targets aimed at delivery. There were 2 evaluations: one in pregnancy and another in postpartum (T(1) and T(2)) including symptoms of depression (EPDS), social support (FSSQ), stress (scale events), the relationship (DAS) and the preterm childbirth.

Results: There was a difference of 11.2 in the percentage of cases at risk of PPD (EPDS≥12): 45.5% (27) in the CG and 34.3% (24) in the EG, without reaching statistical significance (P=.26). The preterm delivery showed significance differences (P=.003), with a decrease in preterm childbirth 4 times lower in the EG.

Conclusions: Overall, the percentage of mothers at PPD risk was higher (P=.02) in women with preterm childbirth. It would be appropriate a global obstetrics and psychiatry approach.