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Does Brief Psychotherapy With Distressed Pregnant Women Benefit Mother and Baby?

Sarah E. Garcia, Nina E. Lillehei, Eleza R. Valente, Nancy K. Grote, Benjamin L. Hankin, and Elysia Poggi Davis

Abstract

Prenatal maternal depression affects both mother and fetus with long-term implications for offspring vulnerability to psychopathology through alterations to brain development, stress physiology, negative emotionality, and cognitive control. This article reviews evidence for the negative impact of prenatal maternal depression on offspring development and describes psychotherapeutic interventions that are used to mitigate prenatal maternal depression and thus, may positively impact infant and child development. The authors then describe an ongoing study to examine the effects on infant development of reducing prenatal maternal depression using a brief form of interpersonal psychotherapy adapted for use with pregnant women.

Maternal depression affects both mother and child and has significant long-term negative effects on infant development and child mental health risk (Goodman et al., 2011). The risks conferred by maternal depression experienced during the postpartum period have long been recognized; indeed mental health interventions have been developed to reduce postpartum maternal depression and, in turn, mitigate risk to child development. In contrast, the unique impact of depression experienced during the prenatal period on offspring development has only recently been understood. The potential positive effects that reducing prenatal depression could have on infant and child development are important to understand as they can set children on an early positive developmental trajectory. In addition, such interventions may be more economically efficient and more likely to reduce personal and societal burden than managing psychological symptoms and problematic behaviors after they arise. In this article, we review the deleterious effects of prenatal depression on fetal development as it relates to risk for later child psychopathology, describe an evidence-based psychosocial intervention for prenatal depression, and discuss how interventions to reduce maternal depression during pregnancy are uniquely situated to have cascading positive effects for both mother and child. Throughout the article we will use a composite case study of “Melissa,” a 24-year-old pregnant, Latina, single mother of a 5-year-old boy “Max,” to illustrate this idea.

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