Preventing Postpartum Depression in Adolescent Mothers

描述（由申请人提供）：青少年生育的后果包括对父母及其子女的重大社会和健康影响。在美国，每年有超过40万名新生儿的母亲不到20岁。怀孕的青少年面临不良生育结果和养育困难的风险增加。产后期间的抑郁症将一个已经具有挑战性的过程转变为一个潜在的压倒性过程。这种困难可能是这些年轻母亲及其子女生活不佳的主要决定因素。显然，预防这一弱势群体的产后抑郁症应该是产前护理的一个组成部分，并对卫生保健提供者和政策制定者特别感兴趣。不幸的是，几乎没有研究检查预防性干预措施对减少怀孕青少年产后抑郁症的影响。这项治疗发展赠款的目的是为经济困难的怀孕少女制定一项社会心理干预措施，并收集关于这种干预措施在减少产后抑郁症程度方面的效果的初步数据。干预主要是一种以人际为导向的干预，针对可能在青少年母亲产后抑郁症的发展中起重要作用的因素（即，社会支持不足、角色转换和生活压力）。该项目的具体目标是：（SA 1）制定干预方案，包括完善干预手册，以反映我们目标人群的需求，并制定依从性和能力量表、治疗师培训程序以及招募和保留受试者的研究程序;（SA2）进行一项随机对照的初步研究，以评估拟议干预措施的初步疗效，并与100例样本中的教导对照条件进行比较。妊娠青少年，并提供与对照条件相比的效应量估计值;以及，（SA 3）评价初步研究结果和程序，以告知干预措施的改进和程序，为评价该干预措施的疗效的更大规模临床试验做准备。这项研究的结果将对预防青少年母亲及其子女的重大发病率产生重要影响。

DESCRIPTION (provided by applicant): The consequences of adolescent childbearing include significant social and health impacts on the parenting teens and their children. Each year, more than 400,000 births in the United States are to mothers less than 20 years old. Pregnant teenagers are at increased risk for adverse birth outcomes and parenting difficulties. Depression during the postpartum period transforms an already challenging process into a potentially overwhelming one. This hardship may be a major determinant of poor outcomes for these young mothers and their children. Clearly, the prevention of postpartum depression with this vulnerable population should be an integral part of prenatal care and of special interest to health care providers and policy makers. Unfortunately, virtually no research has examined the effects of a preventive intervention to reduce postpartum depression in pregnant teenagers. The objective of this treatment development grant is to develop a psychosocial intervention for financially disadvantaged, pregnant adolescents and to collect preliminary data on the efficacy of this intervention in reducing the degree of postpartum depression. The intervention is primarily an interpersonally-oriented intervention that targets those factors that may play a significant role in the development of postpartum depression in adolescent mothers (i.e., poor social support, role transitions, and life stressors). The specific aims of this project are to: (SA1) Develop the intervention program, including refining the intervention manual to reflect the needs of our target population, and developing adherence and competence scales, therapist training procedures, and research procedures for recruitment and retention of subjects; (SA2) Conduct a randomized controlled pilot study to evaluate the initial efficacy of the proposed intervention compared to a didactic control condition in a sample of 100 pregnant adolescents and to provide an estimate of effect size in comparison to the control condition; and, (SA3) Evaluate the pilot study results and procedures to inform the refinement of the intervention and procedures to prepare for a larger clinical trial evaluating the efficacy of this intervention. Findings from this study will have important implications for preventing significant morbidity in adolescent mothers and their children.