Does Interactive Ultrasound Intervention Relieve Minor Depressive Symptoms in Pregnancy? A Randomized Controlled Trial

Abstract BackgroundPerinatal depression, especially minor depression, is common during pregnancy and is likely to continue into the postpartum period. It impairs the mother’s health, infant’s neurodevelopment, and the mother-infant relationship. Screening for perinatal depression is recommended; however, there is no uniform alignment of how to treat depressive symptoms while simultaneously supporting the mother-infant relationship. Ultrasound screenings might be potential as an intervention method because it has shown to improve maternal-fetal attachment among pregnant women. Our aim is to develop a 4 dimensional-based (4D) interactive ultrasound intervention and test whether it relieves minor depressive symptoms and improves maternal-fetal attachment. Previous studies show that supporting the mother-infant relationship aids in relieving maternal depression. Until now, few studies have combined pregnancy ultrasound and psychological support. MethodsA controlled randomized setting was designed to assess whether interactive 4D-ultrasound intervention would decrease maternal depressive symptoms, strengthen maternal-fetal attachment, and mother-infant relationship. A sonographer and a psychologist specialized in infant mental health conduct the interventions. The focus of the session is to jointly observe the behavior of the fetus according to the mothers’ wishes. Altogether, 100 women scoring 10-15 in Edinburgh Pre/-Postnatal Depression Scale (EPDS) and with singleton pregnancy will be recruited using a web-based questionnaire. Half of the participants will be randomized to the intervention group and will receive three interactive ultrasound examinations. The primary outcome is the change in the mean EPDS score. EPDS measurements will be done at three time points: before and after the intervention and four to five months after delivery. The secondary outcomes are maternal representations that will be assessed using the Working Model of the Child Interview (WMCI) and prenatal attachment that will be assessed using the Maternal Antenatal Attachment Scale (MAAS) questionnaire. The postnatal mother-infant interaction will be assessed with the Parent-Child Early Relational Assessment (PCERA) and Maternal Postnatal Attachment Scale (MPAS). DiscussionUltrasound is widely used during pregnancy. The interactive approach is unique and it would be feasible as part of routine screenings and maternity clinic visits. Intervention decreasing depression and simultaneously supporting maternal-fetal attachment could be a valuable addition in treating minor depression among pregnant women. Trial registrationRegistered on January 5th 2018, ClinicalTrials.gov NCT03424642. https://clinicaltrials.gov/ct2/show/NCT03424642