Effectiveness evaluation of the postnatal care intervention ‘Look! - your baby is talking to you’: A complex intervention trial aiming to reduce depressive symptoms among vulnerable mothers

Abstract Background It is widely acknowledged that the postnatal period is crucial in creating a healthy relationship between infant and parent. The mental health of the mother challenges the prerequisites for this process. This study aimed to evaluate whether a short-term intervention delivered to vulnerable mothers during the post-partum stay in hospital reduced the symptoms of depression and impaired well-being three months post partum. Methods All new mothers with a history of maternal depression and/or anxiety were invited to participate in a complex intervention trial where they received either care as usual (n=65) or, after a period where health care professionals were trained, were allocated to the intervention (n=57). Background characteristics and baseline data were collected using online questionnaires 48-72 hours post-partum, and the mothers were followed up regarding mental health three months post-partum. The intervention took place during the planned five-day stay post-partum at the hospital. It consisted of three Newborn Behavioral Observation sessions and three family conversations with trained healthcare professionals, one of which was a meeting including the health visitor from the municipality to improve the transition to the primary healthcare sector. The primary outcome measure was maternal depressive symptoms (Edinburgh Postnatal Depression Scale), and secondary well-being outcome measures were maternal stress (Parental Stress Scale) and Family function (ICE-EFFQ). Differences between the intervention and the non-intervention group were estimated using Poisson and linear regression analyses. Results Mothers in the intervention group showed a small, however not statistically significant, reduction in maternal depressive symptoms three months post-partum (OR 0.80 95% CI 0.36-2.00) when compared to mothers in the non-intervention group. No significant differences between the intervention and non-intervention were found regarding the well-being outcomes, although the results pointed towards an improvement in the intervention group. The observation that all mothers with depressive symptoms in the intervention group participated until the end of follow-up suggests that these mothers found the intervention meaningful. Conclusions In this short-term and easy-to-implement intervention project ‘Look-your baby is talking to you’, maternal depressive symptoms three months after birth were slightly, however not statistically significantly, decreased in the intervention group compared to the non-intervention group.