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Psychosocial Support in the Pandemic: Effects of a Preventive Depression Intervention on Maternal and Infant Outcomes
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2003248
ABSTRACT

Background:

Perinatal depression is a common and undertreated pregnancy complication. Beginning in January 2020, we implemented “Reach Out, Stay Strong, Essentials for New Moms,” (ROSE) an empirically validated 5-session intervention recommended by the U.S. Preventive Services Task Force to prevent perinatal depression (PPD).

Methods:

Our integrated evaluation framework helped us to understand the virtual program delivery adapted due to the COVID-19 pandemic. This included semi-structured provider interviews and surveys, patient questionnaires, and a COVID-19 stressor screen. Two controls matched on maternal age, race, delivery date, zip-code, and infant gender were selected per ROSE participant on a quarterly basis, and maternal and infant outcomes were assessed at nine months post-delivery.

Results:

To date, 68 highrisk pregnant women have been referred, and 57 enrolled in the ROSE program (84% retention, Figure 1). Eight ROSE infants and 16 controls have reached nine months of age and were eligible for review. ROSE participants and controls had similar rates of attendance at a six-week PPD follow-up visit. Participants and controls also attended on average a similar number of well-child visits, had similar rates of screening for PPD at attended visits, and had similar cumulative incidence of positive screens for PPD. ROSE participants and controls had similar rates of initiating breastfeeding. Of those who initiated breastfeeding, ROSE participants had, on average, a longer duration of breastfeeding. Rate of completion of infant vaccination schedules was similar between ROSES participants and controls, with a trend toward reduced vaccination refusal in the ROSE group. Provider stakeholders surveyed feel that the ROSE program is addressing a gap in care by flexibly providing additional mental health services, improving continuity of care through a dedicated program coordinator, and increasing partner engagement. Participants sought out an additional 103 contacts beyond those required by the five sessions of the program.

Conclusion:

Analysis of preliminary data shows trends toward increased duration of breastfeeding and decreased vaccine hesitancy in the ROSE study population. The majority of records reviewed to date are from initial enrollment, which began in a clinic for pregnant mothers with substance use disorder. Stakeholders feel that ROSE is addressing key care needs, particularly in this clinic population, and participants continue to seek engagement with the program outside of required sessions. Our data suggests that ROSE supports high-risk mothers in caring for themselves and their infants after birth. We will continue to review additional infant and maternal health metrics (Figure 2) as enrollment expands and more of our study population reaches nine months post-delivery.
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Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Pediatrics Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Pediatrics Year: 2022 Document Type: Article