Does mindfulness based cognitive therapy improve perinatal mental health outcome? A systematic review. The impact of dispositional mindfulness and social support on the risk of prenatal depression and anxiety among women with hyperemesis gravidarum

Abstract Background: The perinatal period represents a time of heightened risk for the onset or relapse of mental health conditions. Given the potential impact of perinatal mental health conditions on women, infants, and families, acceptable and evidence-based interventions are needed. Mindfulness-based Cognitive Therapy (MBCT) shows promise in its application to a variety of populations, however, its efficacy and acceptability for perinatal women is less clear. Methods: A systematic literature search was conducted using five databases to identify studies reporting standardised MBCT interventions with pregnant and postpartum women. Clinical outcomes included anxiety, depression, stress, and mindfulness. Acceptability of MBCT interventions to perinatal populations was also examined. The ‘Quality Assessment Tool for Quantitative Studies’ was used to quality assess the included articles, and a narrative synthesis was undertaken to summarise the findings. Results: The search identified twelve studies across ten cohorts (total n=480). Methodological quality of studies varied but was generally low. Preliminary evidence indicates that MBCT reduces the severity of perinatal depression and anxiety. Evidence that MBCT increases mindfulness levels is limited. The impact of MBCT on stress related outcomes during the perinatal period has been inadequately tested. Findings suggest support the acceptability of MBCT interventions within this population. Conclusion: The study of MBCT for perinatal populations is still in its infancy, but preliminary findings indicate the intervention the be highly acceptable to perinatal populations and to have promising effects for perinatal depression and anxiety. Recommendations for future research and clinical practice are made