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Perinatal depression intervention did not provide long-term improvement among offspring

The Thinking Healthy Programme, a perinatal depression intervention, did not have long-term effects on children of mothers who received the intervention, according to study findings in the Lancet Psychiatry.

“In the Thinking Healthy Programme cluster-randomized controlled trial, a perinatal depression intervention was delivered by community health workers in rural Pakistan to mothers with perinatal depression. This study was one of the first to show large improvements in depression, even when poverty-related factors were controlled for carefully,” according to study researcher Joanna Maselko, ScD, of Duke University Medical Center, and colleagues. “The trial began in 2005-06 in women in the third trimester of pregnancy and continued for 10 months postpartum.”

Joanna Maselko

In 2013, researchers obtained contact information for mothers in the original Thinking Healthy Programme study cohort to follow up with the mothers and their children. They also enrolled 300 women who did not have prenatal depression at baseline and their children, as a reference group. Mother-child pairs (n = 584) were interviewed twice and children completed cognitive testing. Children had a mean age of 7.6 years.

Overall, cognitive, socioeconomical and physical development outcomes did not differ between children in the intervention and control groups.

Children in the Thinking Healthy Programme trial had worse socioeconomical outcomes compared with children in the control group. Children in the intervention group had higher mean scores on the Strengths and Difficulties Questionnaire for difficulties (P = .03) and on the Spence Children’s Anxiety Scale for anxiety (P = .0013) vs. children in the reference group.

According to researchers, cognitive and physical outcomes did not differ between the intervention and reference groups.

“Maternal depression affects child development, and efforts to diminish its effects should be an integral part of maternal and child health programmes. However, further research is needed to understand the types of interventions that are needed for long-term improvements in a child’s developmental trajectory. Successful interventions could combine a perinatal depression intervention with nutrition and early stimulation programmes,” Maselko and colleagues wrote. “A greater understanding is also needed of how remission of depressive symptoms affects child development…and cultural factors that promote resilience and promote healthy child development.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.