Archives of Women's Mental Health

, Volume 19, Issue 5, pp 779–788 | Cite as

The effect of Wazzup Mama?! An antenatal intervention to prevent or reduce maternal distress in pregnancy

  • Yvonne J. Fontein-KuipersEmail author
  • Marlein Ausems
  • Raymond de Vries
  • Marianne J. Nieuwenhuijze
Original Article


We evaluated the effect of the intervention WazzUp Mama?! on antenatal maternal distress in a non-randomized pre-post study including healthy women in 17 Dutch midwifery practices. The control group (n = 215) received antenatal care-as-usual. The experimental group (n = 218) received the intervention. Data were collected at the first and third trimester of pregnancy. Maternal distress (MD) was measured with the Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI), and Pregnancy-Related Anxiety Questionnaire (PRAQ). We used multivariate repeated-measure analysis to examine the across time changes and ANCOVA was used to examine the differences between the two groups. In the control group, mean EDS, STAI, and MD scores significantly increased from first to third trimester of pregnancy, mean PRAQ scores increased, but not significantly, the proportion of scores above cut-off level of EDS, STAI, and PRAQ significantly increased from first to third trimester, and the proportion of MD scores above cut-off level increased, but not significantly. Within the experimental group, the mean STAI, PRAQ, and MD scores significantly decreased from first to third trimester, the EDS mean scores decreased but not significantly, proportions of scores above cut-off level for PRAQ and MD significantly decreased from first to third trimester of pregnancy, the proportions of EDS and STAI scores above cut-off level decreased but not significantly. There was a moderate significant positive effect of WazzUP Mama?! on the MD scores (F(1.43) = 27.05, p < 0.001, d = 0.5). The results provide support for the effectiveness of the intervention WazzUp Mama?!


Antenatal intervention Maternal distress Depression Anxiety Pregnancy-related anxiety 



The authors would like to thank all the participating midwives, practice assistants, and women who made this study possible and we would like to thank the Promoting Healthy Pregnancy consortium members for their support.

This study is part of the research project ‘Promoting Healthy Pregnancy’, funded by the Regional Attention and Action for Knowledge (RAAK PRO, ref. 2–014). RAAK is managed by the Foundation Innovation Alliance (SIA) with funding from the Ministry of Education, Culture and Science (OCW).

Contribution to authorship

MN and MA designed the study and YF collected and analysed the data. YF drafted the first manuscript. All authors interpreted the data, contributed to discussion and reviewed or edited the manuscript. All authors take responsibility for the integrity of the data and the accuracy of the data analysis. RdV supervised the study and is the guarantor.

Compliance with ethical standards

Ethical approval was obtained by the Medical Ethical Committee Atrium-Orbis Medical Centre Zuyd (registration no. 13-N-45 (11-N-101)/11-4-2013). The study was registered with the Dutch Trial Registration (TC 4688).

Conflict of interest

“All authors declare that: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, no other relationships or activities that could appear to have influenced the submitted work.”


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Yvonne J. Fontein-Kuipers
    • 1
    Email author
  • Marlein Ausems
    • 1
  • Raymond de Vries
    • 1
    • 2
    • 3
  • Marianne J. Nieuwenhuijze
    • 1
  1. 1.Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery ScienceMaastrichtThe Netherlands
  2. 2.Maastricht University Medical Centre/CAPHRIMaastrichtThe Netherlands
  3. 3.Center for Bioethics and Social Sciences in MedicineUniversity of Michigan Medical SchoolAnn ArborUSA

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