TY - JOUR
T1 - Effects of a Prenatal Anxiety Randomized Controlled Trial Intervention on Infant Development in Pakistan
AU - Surkan, Pamela J.
AU - Park, Soim
AU - Sheng, Ziyue
AU - Zaidi, Ahmed
AU - Atif, Najia
AU - Osborne, Lauren
AU - Rahman, Atif
AU - Malik, Abid
N1 - Publisher Copyright:
© 2024 Academic Pediatric Association
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Objective: Given that infant development is influenced by caregiver mental health, we tested whether an intervention to reduce antenatal anxiety could affect infant development. A secondary aim was to test depressive symptoms, maternal responsiveness, and maternal infant bonding as mediators of this relationship. Methods: Between 2020 and 2022, pregnant women participated in a randomized controlled trial of the Happy Mother-Healthy Baby (HMHB) program based on cognitive behavioral therapy. We collected data on child development from 202 intervention and 198 control participants in a public hospital in Pakistan. Child development was measured using the Ages and Stages Questionnaires-Version 3 at six weeks postpartum. Using intent-to-treat analyses, we examined whether the intervention was associated with performance on the five ASQ-3 domains. Causal mediation analysis was used to assess depressive symptoms, bonding, and maternal-infant responsiveness as mediators. Results: Socio-demographic characteristics were evenly distributed between study arms. Intervention arm infants showed a 2.1-point increase (95% CI: 0.12, 4.17) in communication scores compared to controls. Though not achieving statistical significance, intervention infants also showed a 2.0-point increase (95% CI: −0.06, 4.09) in gross motor development performance. Bonding, depression, and responsiveness were mediators between the intervention and infant communication (Bindirect = 1.94 (95% CI: 0.86, 3.25) depression; Bindirect = 0.57 (95% CI: 0.09, 1.16) bonding; Bindirect = 0.53 (95% CI: 0.01, 1.21) and responsiveness (Bindirect = 1.94 (95% CI: 0.86, 3.25)). Bonding, responsiveness, and depression mediated 25%, 23%, and 87% of the total association, respectively. Conclusions: HMHB positively affected infant communication at six-week follow-up. Larger studies with longer follow-up are needed to confirm and extend these findings. Trial registration: ClinicalTrials.gov NCT03880032; https://clinicaltrials.gov/ct2/show/NCT03880032
AB - Objective: Given that infant development is influenced by caregiver mental health, we tested whether an intervention to reduce antenatal anxiety could affect infant development. A secondary aim was to test depressive symptoms, maternal responsiveness, and maternal infant bonding as mediators of this relationship. Methods: Between 2020 and 2022, pregnant women participated in a randomized controlled trial of the Happy Mother-Healthy Baby (HMHB) program based on cognitive behavioral therapy. We collected data on child development from 202 intervention and 198 control participants in a public hospital in Pakistan. Child development was measured using the Ages and Stages Questionnaires-Version 3 at six weeks postpartum. Using intent-to-treat analyses, we examined whether the intervention was associated with performance on the five ASQ-3 domains. Causal mediation analysis was used to assess depressive symptoms, bonding, and maternal-infant responsiveness as mediators. Results: Socio-demographic characteristics were evenly distributed between study arms. Intervention arm infants showed a 2.1-point increase (95% CI: 0.12, 4.17) in communication scores compared to controls. Though not achieving statistical significance, intervention infants also showed a 2.0-point increase (95% CI: −0.06, 4.09) in gross motor development performance. Bonding, depression, and responsiveness were mediators between the intervention and infant communication (Bindirect = 1.94 (95% CI: 0.86, 3.25) depression; Bindirect = 0.57 (95% CI: 0.09, 1.16) bonding; Bindirect = 0.53 (95% CI: 0.01, 1.21) and responsiveness (Bindirect = 1.94 (95% CI: 0.86, 3.25)). Bonding, responsiveness, and depression mediated 25%, 23%, and 87% of the total association, respectively. Conclusions: HMHB positively affected infant communication at six-week follow-up. Larger studies with longer follow-up are needed to confirm and extend these findings. Trial registration: ClinicalTrials.gov NCT03880032; https://clinicaltrials.gov/ct2/show/NCT03880032
KW - antenatal anxiety
KW - cognitive behavioral therapy
KW - maternal infant bonding
KW - randomized controlled trial
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U2 - 10.1016/j.acap.2024.07.018
DO - 10.1016/j.acap.2024.07.018
M3 - Article
C2 - 39097000
AN - SCOPUS:85211636342
SN - 1876-2859
VL - 25
JO - Academic pediatrics
JF - Academic pediatrics
IS - 1
M1 - 102551
ER -