Raghuveer Pracheth, Ransing Ramdas, Kukreti Prerna, Mahadevaiah Mahesh, Elbahaey Wafaa Abdelhakim, Iyengar Satish, Pemde Harish, Deshpande Smita N
Dept. of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India.
Dept. of Psychiatry, BKL Walawalkar Rural Medical College, Sawarde, Maharashtra, India.
Indian J Psychol Med. 2020 Dec;42(6 Suppl):S23-S30. doi: 10.1177/0253717620971559. Epub 2020 Dec 7.
Perinatal depression (PD) has important implications for maternal and infant well-being but largely goes undetected. There is a need to develop low-intensity psychosocial interventions applicable to obstetric health care facilities.
To assess the effectiveness of a brief psychological intervention for mild to moderate PD delivered by a nurse as compared to treatment-as-usual (TAU).
This study is a randomized, open-label, parallel-group, multicentric trial being conducted in four sites of India. A total of 816 pregnant women with mild to moderately severe depression (Patient Health Questionaire-9 score of 5-19) are being assessed for the effectiveness of the intervention. Participants are randomly allocated to two groups of trial intervention (psychological intervention given by nurse) and TAU. The primary outcome is to compare the proportion of women reporting improvement across both groups. Participants are serially followed-up in each trimester and at 6, 10, 14 weeks, and 6 months postpartum. Secondary outcomes include pregnancy outcomes, feeding practices, physical growth, and immunization status of the infants.
It is a prospective pregnancy birth cohort with a robust design and long-term follow-up. This is one of the largest studies utilizing non-specialist health workers for the screening and management of PD. This study also holds promise to cast light on the course and outcome of depression during pregnancy in different parts of India. It is envisaged to help in developing a sound screening and referral-based protocol for obstetric settings.
围产期抑郁症（PD）对母婴健康有重要影响，但很大程度上未被发现。需要开发适用于产科保健机构的低强度心理社会干预措施。
评估与常规治疗（TAU）相比，由护士提供的针对轻度至中度PD的简短心理干预的有效性。
本研究是一项在印度四个地点进行的随机、开放标签、平行组、多中心试验。共有816名轻度至中度严重抑郁症（患者健康问卷-9评分为5-19）的孕妇正在评估该干预措施的有效性。参与者被随机分配到两组，即试验干预组（由护士给予心理干预）和常规治疗组。主要结局是比较两组中报告病情改善的女性比例。在每个孕期以及产后6周、10周、14周和6个月对参与者进行连续随访。次要结局包括妊娠结局、喂养方式、婴儿的身体生长和免疫状况。
这是一个设计完善且有长期随访的前瞻性妊娠分娩队列。这是利用非专业卫生工作者进行PD筛查和管理的最大规模研究之一。本研究也有望揭示印度不同地区孕期抑郁症的病程和结局。预计有助于制定适用于产科环境的完善的筛查和转诊方案。
