The effectiveness of een internet course for pregnant women with depressive and anxiety symptoms

Women in pregnancy and postpartum have an increased vulnerability to develop an affective disorder.
Affective disorders in pregnancy are associated with an increased risk of prematurity, dysmaturity and the development of postpartum depressive disorder. Untreated affective disorders and their complications may also result in considerable costs. Recent meta-analysis showed that interventions during pregnancy are less effective than postpartum interventions probably because of high attrition due to the barriers pregnant women experience withattending sessions outside their homes.
An internet-based self-help intervention may overcome these barriers as it can be followed at home, and also in one’s own time. Such internet interventions showed to be effective for decreasing affective symptoms in general.
This study examines whether an internet-based self-help intervention is effective in reduction of affective symptoms in pregnancy and postpartum and results in an improvement in the perinatal outcome. We will also determine the cost-effectiveness of the intervention.
We present a study protocol to investigate the effectiveness of a 6 week internet-based
self-help problem solving treatment (PST) for affective symptoms in pregnancy in a randomized controlled trial. We aim to include 286 women with mild tot severe affective symptoms who will be randomly assigned to an internet-based intervention or waiting list control group. Primary outcome measures are affective symptoms and the perinatal outcome
Secondary outcome measures are quality of life, and economic costs. Assessments will take place at baseline (T0), after completion of the intervention (T1), 4 weeks before the expected day of birth (T2), and 6 weeks after delivery (T3). The control group will be measured at the same moments in time with the exception of T1. Analysis will be based on the intention-to-treat principle.
If shown effective, internet-based PST will offer new possibilities to treat pregnant women for affective symptoms, to improve their perinatal outcome and to prevent the development of postpartum depressive disorders. It will also improve quality of care and cost effectiveness.

An online intervention will be an effective intervention for treating affective symptoms in pregnancy and their complications by reaching more women and making therapy easier accessible

T0 baseline assessment

T1 10 weeks after inclusion (only for intervention group)

T2 4 weeks before expected delivery date

T3 6 weeks after delivery.

Women who start late in their pregnancy will not be asked to participate in T2

problem solving therapy through the internet