Preventing Postpartum Depression in Adolescent Mothers

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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.