The effect of Wazzup Mama?! An antenatal intervention to prevent or reduce maternal distress in pregnancy
- 399 Downloads
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?!
KeywordsAntenatal 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.”
- Bartholomew L, Parcel G, Kok G, Gottlieb N, Fernàndez M (2011) Planning health promotion programs. An intervention mapping approach, 3rd edition. Jossey-Bass, San FranciscoGoogle Scholar
- Brouwers E, van Baar A, Pop V (2001) Maternal anxiety during pregnancy and subsequent infant development. Infant Behav Dev 24:95--106Google Scholar
- CBS. [Average income: households according to diverse characteristics]. 2014 Available at http://statline.cbs.nl/StatWeb/publication/?DM=SLNL&PA=80048NED&D1=a&D2=a&D3=0&D4=(l-1)-l&VW=T [Accessed April, 2015]
- DiPietro J, Costigan K, Sipsma H (2008) Continuity in self-report measures of maternal anxiety, stress, and depressive symptoms from pregnancy through two years postpartum. J Psychosomatic Obstetrics Gynecology 1:1–10Google Scholar
- Field A (2009) Discovering statistics using SPSS, 3rd edn. SAGE Publications Ltd, LondonGoogle Scholar
- Fontein-Kuipers Y, van Limbeek E, Ausems M, de Vries R, Nieuwenhuijze M (2015a) Using Intervention Mapping for Systematic Development of a Midwife-Delivered Intervention for Prevention and Reduction of Maternal Distress during Pregnancy. Int J Womens Health Wellness 1:008Google Scholar
- Loomans E, van Dijk A, Vrijkotte T, van Eijsden M, Stronks K, Gemke R, et al. Psychosocial stress during pregnancy is related to adverse outcomes: results from a large multi-ethnic community-based birth cohort. The European Journal of Public Health. 2012;1–6Google Scholar
- Mennes M, Stiers P, Lagae L, Van den Bergh B (2006) Long-term cognitive sequelae of antenatal maternal anxiety: involvement of the orbitofrontal cortex. Neurosci Biobehav Rev 30:1078--1086Google Scholar
- MRC (2006) A framework for development and evaluation of RCTs for complex interventions to improve health. Medical Research Council, LondonGoogle Scholar
- Mulder E, Robles de Medina P, Huizink A, Van den Bergh B, Buitelaar J, Visser G (2002) Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Human Development 70:3--14Google Scholar
- PRN (2013) The Netherlands perinatal registry trends 1999–2012. Stichting Perinatale Registratie, UtrechtGoogle Scholar
- RIVM (2013) [Ethnicity: definitions and details] In: Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid versie 4.14. RIVM, BilthovenGoogle Scholar
- Sauro J, Kindlund E. A method to standardize usability metrics into a single score. CHI. 2005;April 2–7:401–409Google Scholar
- Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the state trait anxiety inventory. Consulting Psychologists Press, Palo AltoGoogle Scholar
- Van den Bergh B (1990) The influence of maternal emotions during pregnancy on fetal and neonatal behavior. J Prenatal Perinatal Psychology Health 5:119–130Google Scholar
- Van den Bergh B, Calster B, Smits T, Van Huffel S, Lagae, L (2008) Antenatal maternal anxiety is related to HPA-axis dysregulation and self-reported depressive symptoms in adolescence: A prospective study on the fetal origins of depressed mood. Neuropsychopharmacology 33:536--545Google Scholar
- van der Ploeg H, Defares P, Spielberger C (1980) Manual of self-reported questionnaire. A Dutch translation of the Spielberger State-Trait Anxiety Inventory. Swets and Zeitlinger BV, LisseGoogle Scholar
- Wiesen JP. Benefits, drawbacks, and pitfalls of z-score weighting. Las Vegas: 30th Annual IPMAAC Conference; 2006Google Scholar