The evaluation of acupuncture as an adjunct intervention for antenatal depression : a mixed method study

Abstract

Depression in pregnancy is common; with current prevalence estimates suggesting one in every eight women are affected. Incidence rates amongst vulnerable at-risk groups are however, reportedly much higher. Detrimental consequences are wide-ranging, with associated impacts affecting not only women and immediate family members, but also generations to come. Despite this, research indicates that depressive symptomologies experienced during pregnancy are frequently inadequately managed. A number of factors contribute towards this outcome, including incomplete treatment effectiveness, unacceptable side effects, unsatisfactory relationships with providers, and concerns regarding medication risks to babies. As a consequence, many depressed pregnant women seek out additional therapeutic options. Preliminary clinical trial evidence suggests that acupuncture may provide a safe and potentially effective adjunct treatment; however further investigation is required. This study therefore aimed to further examine acupuncture as an additional therapeutic possibility for the management of depression experienced during pregnancy that also incorporated explorations of women's experiences of receiving acupuncture, and midwives' observations of the intervention. This mixed-methods feasibility study comprised of a comparative effectiveness pragmatic randomised controlled trial (RCT), in which fifty-seven women meeting Edinburgh Postnatal Depression Scale (EPDS) scores of ≥ 13 were randomised to either individually tailored, depressed specific acupuncture, progressive muscle relaxation attention comparator, or treatment as usual control groups. In-depth interviews revealed that acupuncture recipients received multiple benefits from treatment, including feelings of relaxation; an enhanced ability to cope with stress; and an improved psychological state, that overall, contributed to them feeling less overwhelmed, happier, more motivated and positive. Midwives similarly reported in focus groups that they had received positive feedback regarding acupuncture benefits, and in addition, observed improved dispositions in recipients. Furthermore, no adverse events were recorded. The findings from this feasibility study thus provide supportive evidence that acupuncture is beneficial for the management of antenatal depression, stress and distress, as well as enhancing of an overall improved sense of wellbeing. In addition, the individually tailored acupuncture intervention was both well-tolerated and free from adverse events. Further research is therefore warranted.

Date of Award	2018
Original language	English