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Effects of a prenatal anxiety randomized controlled trial intervention on infant development in Pakistan.
Surkan, Pamela J; Park, Soim; Sheng, Ziyue; Zaidi, Ahmed; Atif, Najia; Osborne, Lauren M; Rahman, Atif; Malik, Abid.
Afiliación
  • Surkan PJ; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: psurkan@jhu.edu.
  • Park S; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: soim.park@jhu.edu.
  • Sheng Z; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: zsheng7@jhu.edu.
  • Zaidi A; Human Development Research Foundation, Gujar Khan, Pakistan. Electronic address: ahmed.zaidi@hdrfoundation.org.
  • Atif N; Human Development Research Foundation, Gujar Khan, Pakistan. Electronic address: najia.atif@hdrfoundation.org.
  • Osborne LM; Department of Obstetrics & Gynecology, Weill Cornell Medical College, New York, NY, USA. Electronic address: lmo2003@med.cornell.edu.
  • Rahman A; Institute of Population Health, University of Liverpool, Liverpool, United Kingdom. Electronic address: atif.rahman@liverpool.ac.uk.
  • Malik A; Department of Public Mental Health, Health Services Academy, Chak Shahzad, Islamabad, Pakistan. Electronic address: abid.malik@hsa.edu.pk.
Acad Pediatr ; 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-39097000
ABSTRACT

OBJECTIVES:

Given that infant development is influenced by caregiver mental health, we tested whether an intervention to reduce antenatal anxiety could affect infant development. A secondary aim was to test depressive symptoms, maternal responsiveness, and maternal infant bonding as mediators of this relationship.

METHODS:

Between 2020 and 2022, pregnant women participated in a randomized controlled trial of the Happy Mother-Healthy Baby (HMHB) program based on cognitive behavioral therapy. We collected data on child development from 202 intervention and 198 control participants in a public hospital in Pakistan. Child development was measured using the Ages and Stages Questionnaires-Version 3 at six weeks postpartum. Using intent-to-treat analyses, we examined whether the intervention was associated with performance on the five ASQ-3 domains. Causal mediation analysis was used to assess depressive symptoms, bonding, and maternal-infant responsiveness as mediators.

RESULTS:

Socio-demographic characteristics were evenly distributed between study arms. Intervention arm infants showed a 2.1-point increase (95% CI 0.12, 4.17) in communication scores compared to controls. Though not achieving statistical significance, intervention infants also showed a 2.0-point increase (95% CI-0.06, 4.09) in gross motor development performance. Bonding, depression, and responsiveness were mediators between the intervention and infant communication (Bindirect=1.94 (95%CI 0.86, 3.25) depression; Bindirect=0.57 (95% CI 0.09, 1.16) bonding; Bindirect=0.53 (95% CI 0.01, 1.21) responsiveness; and Bindirect=1.94 (95%CI 0.86, 3.25). Bonding, responsiveness, and depression mediated 25%, 23%, and 87% of the total association, respectively.

CONCLUSIONS:

HMHB positively affected infant communication at six-week follow-up. Larger studies with longer follow-up are needed to confirm and extend these findings. TRIAL REGISTRATION ClinicalTrials.gov NCT03880032; https//clinicaltrials.gov/ct2/show/NCT03880032.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Acad Pediatr Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Acad Pediatr Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos