Mamma Mia - A randomized controlled trial of an internet-based intervention for perinatal depression

Silje Marie Haga, Filip Drozd, Carina Lisøy, Tore Wentzel-Larsen, Kari Slinning, Silje Marie Haga, Filip Drozd, Carina Lisøy, Tore Wentzel-Larsen, Kari Slinning

Abstract

Background: Studies suggest that 10-15% of perinatal women experience depressive symptoms. Due to the risks, problems with detection, and barriers to treatment, effective universal preventive interventions are needed. The aim of this study was to assess the effectiveness of an automated internet intervention ('Mamma Mia') on perinatal depressive symptoms. Mamma Mia is tailored specifically to the perinatal phase and targets risk and protective factors for perinatal depressive symptoms.

Methods: A total of 1342 pregnant women were randomized to an intervention ('Mamma Mia') and control group. Data were collected at gestational week (gw) 21-25, gw37, 6 weeks after birth, and 3 and 6 months after birth. We investigated whether (1) the intervention group displayed lower levels of depressive symptoms compared with the control group, (2) the effect of Mamma Mia changed over time, (3) the effect on depressive symptoms was moderated by baseline depressive symptoms, previous depression, and parity, and (4) this moderation changed by time. Finally, we examined if the prevalence of mothers with possible depression [i.e. Edinburgh Postnatal Depression Scale (EPDS)-score ⩾10] differed between the intervention and control group.

Results: Participants in the Mamma Mia group displayed less depressive symptoms than participants in the control group during follow-up [F(1) = 7.03, p = 0.008]. There were indications that the effect of Mamma Mia was moderated by EPDS score at baseline. The prevalence of women with EPDS-score ⩾10 was lower in the Mamma Mia group at all follow-up measurements.

Conclusions: The study demonstrated the effects of the automated web-based universal intervention Mamma Mia on perinatal depressive symptoms.

Keywords: Internet intervention; linear mixed effects models; perinatal depression; randomized controlled trial; universal prevention.

Figures

Fig. 1.
Fig. 1.
Participant flowchart.
Fig. 2.
Fig. 2.
Mamma Mia and control group trajectories of depressive symptoms. Numbers at baseline are means, while numbers during follow-up are model-based estimates.
Fig. 3.
Fig. 3.
Percentages of women with EPDS-scores ⩾10 in the Mamma Mia and control group across time.

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