Outcomes of Mindful Mood Balance for Moms, online mindfulness-based cognitive therapy for perinatal depressive relapse prevention in the USA: a two-arm, single-blind, pragmatic randomised clinical trial.

In 30 seconds

This single-blind, pragmatic randomised clinical trial tested a web-based mindfulness-based cognitive therapy programme plus usual care against usual care alone in euthymic pregnant women with recurrent depression and recent or current antidepressant use. Among 500 participants, depressive relapse through 6 months postpartum occurred in 33% assigned to the programme and 44% receiving usual care (hazard ratio 0·74 [95% CI 0·56–0·99]; p=0·045). Depression symptom burden decreased more with the programme during its 12-week intervention, but the difference was not sustained across the full trial period.

Key findings

• Relapse through 6 months postpartum affected 81 (33%) of 249 programme participants and 111 (44%) of 251 usual-care participants (hazard ratio 0·74 [95% CI 0·56–0·99]; p=0·045).
• During the 12-week intervention, average symptom-burden decrease was 0·75 [SE 0·13] with the programme and 0·31 [0·13] with usual care.
• Across the full trial period, symptom-burden decreases were 0·61 [SE 0·18] and 0·54 [0·17], respectively; the difference was not significant.

Why it matters

Depressive relapse during pregnancy and postpartum is a significant public health concern. This trial suggests that an accessible, web-based psychological programme may reduce relapse risk when added to usual care for pregnant women with recurrent depression, while symptom improvement appears concentrated during the intervention. The findings add evidence for non-pharmacological support in perinatal relapse prevention.

What to keep in mind

Assessment data were available for 77% of participants at 3 months and 78% at 6 months postpartum; symptom-burden reduction was not significant across the full trial period.