Effect of Peer Support on Anxiety, Self-Esteem and Postnatal Depression: A One Tailed Randomized ControlledTrial

Abstract

Abstract: Introduction: Women during pregnancy and after delivery according to their special requirements and the changes that occur in their roles and responsibilities are vulnerable to emotional problems such as anxiety, low self-esteem and depression. One of the factors affects women's mental health improvement during pregnancy and postpartum is social support and considering that social ties and relationships with people who have similar conditions has impact on maternal mental health, and since the study about this subject was rare in Iran, this study was conducted aimed to evaluate the effect of peers support on anxiety, self-esteem and postpartum depression. Methods: This study is a single-blind clinical trial which was conducted in 2012 in Tabriz health centers. 100 eligible primiparous women participated in trial. Samples who gained a score of 11-23 in Edinburgh depression survey randomly assigned to intervention and control groups. The intervention group received phone calls by their peers from the last three months of pregnancy until two months after delivery. The control group only had access to routine care. Peers were mothers with a history of delivery (natural or cesarean) and successful breastfeeding. Both groups in the second month after delivery were checked regarding anxiety, self-esteem and depression. Data analysis was performed using SPSS 18, descriptive statistics test, t-test, chi-square test and covariance analysis. Results: Mean (SD) state anxiety score in the control group was 44.4(9.6) and in the intervention group was 46.6(7.8). After intervention in the second month of postpartum, the mean (SD) anxiety in the control group was 43.16(9.2) and in the intervention group was 40.64(9.2). Difference in the reduction of mean SA score between the two groups showed statistically significant difference (P=0.023). In week 8 after delivery Trait anxiety scores decreased in both groups, but the difference was not significant between them. Comparisons between two groups in change scores of self-esteem did not show statistically significant differences. Results about mean depression scores before and after intervention in two groups showed that; mean depression score before intervention was 13.9(3.23) in the control group and 14.06(3.12) in the intervention group. In week 8 after delivery, mean score of depression in the control group was 13.3(4.08) but in the intervention group it was reduced to 10.25(4.18). Difference in the reduction of mean postpartum depression scores between them showed statistically significant difference (p<0.001). Conclusion: this study showed that peer support was effective in the prevention of postpartum anxiety and depression, therefore, it is recommended to be used in the reduction of postpartum anxiety and depression and along with routine cares, and facilities of peer support can be established to communication and exchange of experience between mothers and their peers.