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正念团体疗法对双胎妊娠产妇心理困扰及围产期结局的影响:一项随机对照试验

Effect of mindfulness group therapy on maternal psychological distress and perinatal outcomes in twin pregnancy: a randomized controlled trial.

作者信息

Zhou Ying, Tang Zai-Mei, Mei Lin, Yang Xiao-Chang, Zheng Hong-Ling, Liao Bi-Zhen, Yu Xin-Yang

机构信息

Department of Obstetrics and Gynecology, Chongqing Key Laboratory of Maternal and Fetal Medicine/Joint International Research Laboratory of Reproduction & Development, Ministry of Education/The Innovation and Talent Recruitment Base of Maternal-Fetal Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

School of Marxism, Chongqing University, Chongqing, China.

出版信息

Front Psychiatry. 2025 May 20;16:1572633. doi: 10.3389/fpsyt.2025.1572633. eCollection 2025.

Abstract

PURPOSE

Psychosocial stress, depression, and anxiety are prevalent during pregnancy and can be associated with adverse birth outcomes. This study aimed to evaluate the effectiveness of an online Mindfulness Group Therapy (MGT) program in improving perinatal maternal psychological distress and perinatal outcomes among women with twin pregnancies.

METHODS

In this randomized controlled trial, 120 women carrying twins were assigned to MGT groups (6-week, 120 minutes of mindfulness intervention weekly) or control groups (usual perinatal care and health education). The primary outcomes were maternal psychological distress, including depression, anxiety, stress, and mindfulness measured by the Edinburgh Postnatal Depression Scale, State Anxiety Inventory, Perceived Stress Scale, and Five Facet Mindfulness Questionnaire at three points: baseline, post-intervention and time one month postpartum. Secondary outcomes included maternal pregnancy outcomes and neonatal outcomes.

RESULTS

A total of 109 women with twin pregnancies completed the intervention. The intervention significantly and effectively prevented the worsening of postpartum depression symptoms in women with twin pregnancies, improved mindfulness, and reduced perceived stress (P < 0.05). Significant differences were observed at both post-intervention, and 1-month post-delivery (P < 0.05). However, no significant differences were found in anxiety scores (P > 0.05). Intention-to-treat analysis further revealed that the intervention had a significant effect on reducing postpartum depressive symptoms (P < 0.05), even when considering participants who did not complete the entire study process. In terms of pregnancy outcomes, a significant difference was found between the intervention and control groups in the incidence of low birth weight (P<0.05).

CONCLUSION

MGT proves potentially effective in reducing perinatal stress, preventing prenatal depression, and decreasing the incidence of low-birth-weight infants in twin pregnancies. These findings support the integration of group mindfulness interventions into prenatal mental health care to mitigate prenatal depression among women expecting twins.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/showproj.html?proj=131787, identifier ChiCTR2100050091.

摘要

目的

心理社会压力、抑郁和焦虑在孕期很常见,且可能与不良分娩结局相关。本研究旨在评估在线正念团体治疗(MGT)项目在改善双胎妊娠女性围产期心理困扰及围产期结局方面的有效性。

方法

在这项随机对照试验中,120名双胎妊娠女性被分配到MGT组(为期6周,每周进行120分钟的正念干预)或对照组(常规围产期护理和健康教育)。主要结局是产妇心理困扰,包括在三个时间点通过爱丁堡产后抑郁量表、状态焦虑量表、感知压力量表和五因素正念问卷测量的抑郁、焦虑、压力和正念:基线、干预后和产后1个月。次要结局包括产妇妊娠结局和新生儿结局。

结果

共有109名双胎妊娠女性完成了干预。该干预显著且有效地预防了双胎妊娠女性产后抑郁症状的恶化,提高了正念水平,并降低了感知压力(P<0.05)。在干预后和分娩后1个月均观察到显著差异(P<0.05)。然而,焦虑评分未发现显著差异(P>0.05)。意向性分析进一步显示,即使考虑未完成整个研究过程的参与者,该干预对降低产后抑郁症状也有显著效果(P<0.05)。在妊娠结局方面,干预组和对照组在低出生体重发生率上存在显著差异(P<0.05)。

结论

MGT被证明在减轻双胎妊娠围产期压力、预防产前抑郁和降低低出生体重婴儿发生率方面可能有效。这些发现支持将团体正念干预纳入产前心理健康护理,以减轻双胎妊娠女性的产前抑郁。

临床试验注册

https://www.chictr.org.cn/showproj.html?proj=131787,标识符ChiCTR2100050091。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10be/12130052/d67f99cd9847/fpsyt-16-1572633-g001.jpg

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