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Randomized Controlled Trial
. 2015 Jan;19(1):102-11.
doi: 10.1007/s10995-014-1500-5.

Effects of a psychosocial couple-based prevention program on adverse birth outcomes

Mark E Feinberg  1 , Michael E Roettger, Damon E Jones, Ian M Paul, Marni L Kan
Affiliations
Randomized Controlled Trial

Effects of a psychosocial couple-based prevention program on adverse birth outcomes

Mark E Feinberg et al. Matern Child Health J. 2015 Jan.

Abstract

Although maternal stress and depression have been linked to adverse birth outcomes (ABOs), few studies have investigated preventive interventions targeting maternal mental health as a means of reducing ABOs. This randomized controlled study examines the impact of Family Foundations (FF)-a transition to parenthood program for couples focused on promoting coparenting quality, with previously documented impact on maternal stress and depression-on ABOs. We also examine whether intervention buffers birth outcomes from the negative effect of elevated salivary cortisol levels. We use intent-to-treat analyses to assess the main effects of the FF intervention on ABOs (prematurity, birth weight, pregnancy complications, Cesarean section, and days in hospital for mothers and infants) among 148 expectant mothers. We also test the interaction of cortisol with intervention condition status in predicting ABOs. FF participation was associated with reduced risk of C-section (OR .357, p < 0.05, 95 % CI 0.149, 0.862), but did not have main effects on other ABOs. FF significantly buffered (p < 0.05) the negative impact of maternal cortisol on birth weight, gestational age, and days in hospital for infants; that is, among women with relatively higher levels of prenatal cortisol, the intervention reduced ABOs. These results demonstrate that a psycho-educational program for couples reduces incidence of ABOs among higher risk women. Future work should test whether reduced maternal stress and depression mediate these intervention effects.

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Figures

Fig. 1
Fig. 1
Interaction of intervention condition and maternal pretest cortisol predicting child birth weight
Fig. 2
Fig. 2
Interaction of intervention condition and maternal pretest cortisol predicting gestational age (weeks)
Fig. 3
Fig. 3
Interaction of intervention condition an maternal pretest cortisol predicting newborn length of stay
See this image and copyright information in PMC

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