The feasibility of acupuncture as an adjunct intervention for antenatal depression: a pragmatic randomised controlled trial.
BACKGROUND
Antenatal depression is common and associated with adverse consequences for mothers, babies, and future generations. Limitations with conventional approaches has resulted in additional therapies being considered. This study examined the feasibility and effectiveness of acupuncture for improving mental health.


METHODS
Fifty-seven pregnant women with depressive symptomologies were randomised to acupuncture (n=19) plus treatment as usual (TAU), progressive muscle relaxation (PMR, n=19) plus TAU or TAU (n=19). Treatments were conducted from 24 to 31 weeks gestation. Clinical assessments were performed throughout the intervention, as well as at a six-week postnatal follow-up. The primary outcome measure was depression. Secondary outcome measurements were stress, anxiety, psychological distress, quality of life and adjustment to mothering. Intention to treat (ITT), Linear Mixed Model (LMM) repeated measures and per protocol (PP) analyses were conducted.


RESULTS
At end-of-intervention there were significantly lower depression scores in the acupuncture group versus TAU and PMR respectively [ITT p<0.001, mean difference (MD) -5.84 (95% CI -9.10 to -2.58); MD -3.42 (95% CI -6.64 to -0.20)]. LMM repeated measures analysis (including postnatal follow-up) also demonstrated significantly lowered acupuncture group scores for stress (p=0.006) and psychological distress (p<0.001) when compared to PMR and TAU. Between group differences were not significant at six-weeks postnatal. No adverse events were reported.


LIMITATIONS
Main limitations are small sample size and the use of self-reported outcome measures.


CONCLUSION
Prenatal acupuncture reduced depression, stress and distress, whilst also being well-tolerated and free from adverse events. Further research is warranted.
['Ormsby|Simone M|SM|', 'Smith|Caroline A|CA|', 'Dahlen|Hannah G|HG|', 'Hay|Phillipa J|PJ|']
D015670:Acupuncture Therapy D003863:Depression D003866:Depressive Disorder D005240:Feasibility Studies D005260:Female D006801:Humans D011247:Pregnancy D011788:Quality of Life
Acupuncture antenatal depression stress anxiety clinical trial