The Effect of Lifestyle-based Education to Women and their Husbands on the Anxiety and Depression during Pregnancy and Postpartum: A Randomized Controlled Trial

Abstract

Abstract: Background: Pregnancy and after childbirth, especially the first 6-8 week safer childbirth is the most important vulnerable period to developing mental disorders. Due to complications of pregnancy and postpartum anxiety and depression, this study aimed to determine the effect of lifestyle-based training of women and their husbands on pregnancy and postpartum anxiety and depression. Methods: This randomized controlled clinical trial was conducted on 189 literate non depressed pregnant women with gestational age of 24-28 weeks and follow-ups continued up to 6 weeks after childbirth. eligible subjects were allocated by stratified (based on number of delivery) randomization method into three groups of receiving lifestyle-based education along with husbands’ education (first intervention group), receiving lifestyle-based education without husbands’ education (second intervention group), and receiving routine care. Edinburgh depression scale and Spiel Berger State-Trait Anxiety questionnaires was completed by participants before the intervention, 8 weeks after the intervention and 6 weeks after childbirth. General linear models were used to analyze the data. Findings: No statistically significant difference was observed between the groups in terms of the demographic characteristics and baseline score of anxiety and depression before intervention(p(05/0<. By adjusting for baseline scores, compared to the control group, the mean depression scores 8 week after intervention were significantly reduced in the first intervention group (adjusted difference -4.7; 95% CI -5.9 to -3.4) and second intervention group (-2.9; -4.1 to -1.6). The mean depression score was significantly reduced in the first intervention group compared to the second intervention group (-1.9, -3 to -0.6). Also by adjusting for baseline scores, compared to the control group, the mean depression scores 6 week after childbirth was significantly reduced in the first intervention group (adjusted difference: -5.5; 95% CI: -7.3 to -3.6) and second intervention group (-3.2; -5.1 to -1.3). Also the mean depression score was significantly reduced in the first intervention group compared to the second intervention group (-2.2; -4.1 to -0.4). Compared to the control group the mean state anxiety scores 8 week after intervention in the first intervention group (-8.1; -11.3 to -4.9) and second intervention group (-4.3; -7.5 to -1.1) was significantly reduced. The mean state anxiety score was also significantly reduced in the first intervention group compared to the second intervention group (-3.7, -6.9 to -0.5).Also by adjusting for baseline scores, compared to the control group, the mean state anxiety scores 6 week after childbirth in the first intervention group (-13.6; -17.7 to -9.5) and second intervention group (-5.8; -10.0 to -1.7)was significantly reduced. The mean state anxiety score was also significantly reduced in the first intervention group compared to the second intervention group (-7.8, -11.9 to -3.6). Compared to the control group, the mean trait anxiety score 8 week after intervention was significantly reduced in the first intervention group (-8.3; -11.5 to -5.0) and second intervention group (-5.5; -8.7 to -2.3); however, no significant difference was observed between the two intervention groups (-2.7, -6.0 to 0.4).Also by adjusting for baseline scores, compared to the control group, the mean state anxiety scores 6 week after childbirth in the first intervention group (-12.6; -16.7 to -8.4) and second intervention group (-4.9; -9.0 to -0.8)was significantly reduced. In addition the mean state anxiety score was also significantly reduced in the first intervention group compared to the second intervention group (-7.7; -11.8 to -3.5). Conclusion: This study Showed, that the effect of lifestyle based education on reducing anxiety and depression during pregnancy and after childbirth. Given that education to both couples compared to education to women alone was more effective, therefore It is recommended that men be involved in the training program offered to pregnant women.