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Postpartum Depression (PPD)PREPPNCT03283254

PREPP: Preventing Postpartum Depression

A study testing Practical Resources for Effective Postpartum Parenting (PREPP) and Enhanced Treatment As Usual (ETAU) in people with Postpartum Depression (PPD), run by Columbia University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary aim of this study is to determine if a behavioral intervention targeting maternal caregiving of young infants can increase infant sleep and reduce fuss/cry behavior, and thereby (1) reduce the incidence and/or severity of postpartum maternal depression and (2) improve the quality of the mother-infant… Read more about this study

Who is it for?
Ages 18 to 45 years, women onlyHealthy volunteers can take part
Conditions the study is for
Postpartum Depression (PPD)
What is being tested?
Practical Resources for Effective Postpartum Parenting (PREPP) and Enhanced Treatment As Usual (ETAU)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
216 participants
Where
1 siteUnited States
Study dates
12 Feb 2018to 28 Feb 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy pregnant women between 18-45 years old (based on self report)
  • A score of ≥19 on the Predictive Index of Postnatal Depression (PIPD), indicating risk for developing postpartum depression or score of ≥7 on the Edinburgh Postnatal Depression Scale
  • A healthy, singleton pregnancy (based on self report)
  • English speaking (based on self report)
  • Receiving standard prenatal care (based on self report)

Who cannot join

  • Multi-fetal pregnancy (based on self-report)
  • Smoking, illicit drug use, or alcohol use during pregnancy (based on self-report)
  • Acute medical illness or significant pregnancy complication (based on self-report)
  • Currently in weekly, individual psychotherapy, including psychopharmacology (based on self report)
  • Psychotic d/o; Bipolar I; Major Depressive d/o (based on M.I.N.I.)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • New York State Psychiatric Institute

    New York, New York, 10032

Other trials in United States

About this study

Official title: Preventing Postpartum Depression: A Dyadic Approach Adjunctive to Obstetric Care

The primary aim of this study is to determine if a behavioral intervention targeting maternal caregiving of young infants can increase infant sleep and reduce fuss/cry behavior, and thereby (1) reduce the incidence and/or severity of postpartum maternal depression and (2) improve the quality of the mother-infant interaction and subsequent child development. Specifically, the study team will investigate: (1) the effectiveness of the intervention compared to usual care; (2) if the effects of the intervention can be detected in the assessments of the quality of mother-infant interaction; (3) if there are prenatal and/or postnatal biomarkers that can help identify infants whose behavior is more likely to play a role in their mothers' depression; (4) if these markers differentiate which infants will be most responsive to the intervention(s); and (5), if assessments of brain function at birth and at 4-6 weeks of age provide biological nodal points for identifying the effects of the intervention on infant brain development. Participants will be recruited during their 2nd trimester, and will be randomly separated into one of two groups: a group that receives coaching in parenting techniques 3 coaching sessions and 2 check-in sessions or one that receives treatment as usual.

Read the detailed description

Of the nearly 4 million mothers delivering live births each year in the United States, approximately 560,000 - or 14% - will develop major or minor depression within the first four months postpartum, when the rate peaks. This number dwarfs prevalence rates for gestational diabetes (2-5%) and is comparable to preterm birth (11.4%). Postpartum depression (PPD) has substantial consequences: poorer maternal quality of life, significant emotional suffering, and suicide risk. PPD predicts diminished mother-infant bonding, and poor outcomes in social-emotional and, in some groups, cognitive development. PPD is undertreated in part because women are reluctant to seek treatment due to the stigma associated with mental health care, logistical barriers to at-tending added health care appointments, and disinclination to take medications while breastfeeding. Of preventive interventions, few embed services in obstetrical care or leverage the unique mother-infant dyadic orientation of the childbearing period. The investigators developed a novel intervention based on the conceptualization of maternal depression as a potential disorder of the mother-infant dyad, and one that can be approached through psychological and behavioral changes in the mother - commencing before birth - that affect her and the child. PREPP (Practical Resources for Effective Postpartum Parenting) enrolls distressed pregnant women at risk for PPD, spans late pregnancy to the 6 week postpartum check up, comprises four in-person 'coaching' sessions adjunctive to obstetrical (OB) prenatal and postnatal appointments, one phone session, and imparts (a) mindfulness and self-reflection skills, (b) parenting skills, and (c) psycho-education.

Being tested
Practical Resources for Effective Postpartum Parenting (PREPP), Enhanced Treatment As Usual (ETAU)
Keywords
Postpartum Depression Treatment
Medical subject headings
Depression, Postpartum

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Practical Resources for Effective Postpartum Parenting (PREPP)Behavioural

    Also called PREPP

    A preventive psychotherapy intervention for PPD: Participants in this arm of the study receive PREPP (Practical Resources for Effective Postpartum Parenting). PREPP is a brief preventive intervention for Postpartum Depression that focuses on the birthing parent-infant dyad and consists of 5 sessions that take place during pregnancy through 6 weeks postpartum carried out by study clinicians referred to as 'coaches.' The sessions of this preventive psychotherapy are comprised of three components: (a) mindfulness and self-reflection skills, (b) parenting skills and (c) psycho-education.

  • Enhanced Treatment As Usual (ETAU)Behavioural

    Also called ETAU

    Psychoeducation, Clinical Assessment, Potential Referral: Participants receive "usual care" along with Postpartum Depression psychoeducation and enhanced support for finding perinatal mental healthcare treatment when appropriate by meeting with a study clinician specifically assigned to provide ETAU in this study at three times that are aligned with PREPP sessions that span from pregnancy to 6 weeks postpartum. At the first contact, participants meet with their assigned ETAU clinician and are given information about PPD, a brief clinical mental health assessment, and a referral for treatment if warranted or requested; the second session is a follow-up mental health clinical assessment with the study clinician and a referral for treatment if warranted or requested; at the third session, participants meet again with their study clinician and receive a mental health assessment, review relevant psychoeducation on PPD and are referred to treatment when appropriate.

Study groups in NCT03283254
Study groupRoleWhat they receive
Practical Resources for Effective Postpartum (PREPP)ExperimentalA psychotherapeutic preventive intervention that involves psychoeducation and cognitive behavioral techniques.
Receives: Behavioral: Practical Resources for Effective Postpartum Parenting (PREPP)
Enhanced Treatment as UsualActive comparatorPsychoeducation about Postpartum Depression, referral to treatment in the community and monitoring
Receives: Behavioral: Enhanced Treatment As Usual (ETAU)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Score on the Edinburgh Postnatal Depression Scale (EPDS)

    Maternal mood: Postpartum Depression Symptoms will be measured by Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a 10-item questionnaire that was developed to identify women who have postpartum depression. Items of the scale correspond to various clinical depression symptoms, such as guilt feeling, sleep disturbance, low energy, anhedonia, and suicidal ideation. Overall assessment is done by total score, which is determined by adding together the scores for each of the 10 items. Scores range from 0 to 30, with higher scores indicate more depressive symptoms (worse outcome).

    Measured: Baseline, 6 weeks, 12 weeks, and 16 weeks postpartum

  2. Score on the Pittsburgh Sleep Quality Index (PSQI)

    Maternal perception of sleep quality: The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire that assesses sleep quality and disturbances over a 1-month time interval. A total of 19 individual items generate 7 "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Scores range from 0 to 21, where lower scores indicate a healthier sleep quality (better outcome).

    Measured: Baseline, 6 weeks, 12 weeks, and 16 weeks postpartum

  3. Score on HRSD-24

    The Hamilton Rating Scale for Depression (HRSD), also called the Hamilton Depression Rating Scale (HDRS), sometimes also abbreviated as HAM-D, is a multiple-item questionnaire used to provide an indication of depression, and as a guide to evaluate recovery. The patient is rated on 24 items scored either on a 3-point (0-2) or 5-point (0-4) Likert-type scale. Total scores range from 0 to 74 with a lower score indicating a better outcome.

    Measured: Baseline, 6 weeks, 12 weeks, and 16 weeks postpartum

  4. Score on the PHQ-9

    The nine-item Patient Health Questionnaire (PHQ-9) is a depressive symptom scale and diagnostic tool introduced in 2001 to screen adult patients in primary care settings. The instrument assesses for the presence and severity of depressive symptoms and a possible depressive disorder. It is scored by simply adding up the individual items' scores. Scores range from 0 to 27 with a lower score indicating a better outcome.

    Measured: Baseline, 6 weeks, 12 weeks, and 16 weeks postpartum

  5. Hamilton Anxiety Scale (HRSA)

    The scale consists of 14 items designed to assess the severity of a patient's anxiety. The patient is rated by on 14 items scored on a 5-point (0-4) Likert-type scale. Total scores range from 0 to 56 with a lower score indicating a better outcome.

    Measured: Baseline, 6 weeks, 12 weeks, and 16 weeks postpartum

  6. Sleep Efficiency (SEact) of the Mothers

    Sleep Efficiency (SEact) was measured by an activity monitor worn by the participants continuously over 7 days. SEact is reported as a percent of time spent asleep during the total time spent in bed.

    Measured: 28-32 weeks gestation (prenatal), 34-39 weeks gestation (prenatal), 6 weeks postpartum, 16 weeks postpartum

Secondary outcomes (7)
  1. Total Nocturnal Sleep Duration - Brief Infant Sleep Questionnaire (BISQ)

    The BISQ is a parent-reported questionnaire on infants/toddler (0-29 months) sleep over 7 days

    Measured: 6 weeks and 16 weeks postpartum

  2. Total Daytime Sleep Duration - Brief Infant Sleep Questionnaire (BISQ)

    The BISQ is a parent-reported questionnaire on infants/toddler (0-29 months) sleep over 7 days.

    Measured: 6 weeks and 16 weeks postpartum

  3. Total Number of Instances of Waking up at Night - Brief Infant Sleep Questionnaire (BISQ)

    The BISQ is a parent-reported questionnaire on infants/toddler (0-29 months) sleep over 7 days.

    Measured: 6 weeks and 16 weeks postpartum

  4. Total Settling Time to Fall Asleep for the Night - Brief Infant Sleep Questionnaire (BISQ)

    The BISQ is a parent-reported questionnaire on infants/toddler (0-29 months) sleep over 7 days.

    Measured: 6 weeks and 16 weeks postpartum

  5. Daily Minutes of Infant Crying Over 4 Days

    Cry behavior will be measured by The Baby Day Diary, which is a 24-hour diary of infant and parental behavior for days. The number of minutes for the crying behavior is averaged over a span of 4 days, with a higher number indicating a worse outcome.

    Measured: 6 weeks and 16 weeks postpartum

  6. Length of Longest Sleep at Night for Infants Over 4 Days

    Sleep behavior will be measured by The Baby Day Diary, which is a 24-hour diary of infant and parental behavior for days. The number of minutes of sleep is averaged over a span of 4 days. A higher number indicates a better outcome.

    Measured: 6 weeks and 16 weeks postpartum

  7. Total Sleep Time (TSTact) in the Mothers

    TSTact was measured by an activity monitor worn by the participants continuously over 7 days.

    Measured: 28-32 weeks gestation (prenatal), 34-39 weeks gestation (prenatal), 6 weeks postpartum, 16 weeks postpartum

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Sep 2017
  2. Study start12 Feb 2018
  3. Primary completion28 Feb 2024
  4. Study completion28 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two groups: One receives PREPP prevention intervention and the other group receives Enhanced Treatment as Usual (psychoeducation about Postpartum Depression, referral and monitoring)
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
216 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03283254
Sponsor's protocol ID
AAAV4354
Other IDs
R01HD092062, 7428
Acronym
PREPP
Status last verified
Sep 2025
First submitted
14 Aug 2017
Last updated
26 Sep 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified data may be made available to other researchers.

Questions about this trial

What is this clinical trial studying?

A study testing Practical Resources for Effective Postpartum Parenting (PREPP) and Enhanced Treatment As Usual (ETAU) in people with Postpartum Depression (PPD), run by Columbia University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Sep 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Score on the Edinburgh Postnatal Depression Scale (EPDS) (time frame: Baseline, 6 weeks, 12 weeks, and 16 weeks postpartum). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Sep 2025.

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