Predicting maternal mental health and pre-school child development in a high risk first pregnancy cohort that includes a nested preventative RCT

This thesis is concerned with a 31/2 year follow up of mothers (n = 114) and their first born children (n = 116, including 2 sets of twins). When pregnant with these children the mothers participated in a randomised controlled trial (RCT) of a psychosocial intervention known as Preparing for Parenthood (PFP), which was designed to prevent maternal depression. This follow-up is the latest of seven main stages of the PFP research programme: (1) women were screened for sub-clinical depression (n = 1300), those who screened positive were thereby identified as at high risk of maternal depression (n = 400); and (2) underwent baseline assessments (n = 292); (3) the women were randomised (n = 209) to continue standard antenatal care or, in addition, randomised women were followed-up at 3 months after childbirth (n = 190); (6) also, at 12 months after childbirth (n = 180) at which point, their first born children were followed-up (n=182, including 2 sets of twins). In this seventh stage of the research programme, the aims were to: (1) evaluate the long-term effectiveness of the intervention, testing the hypotheses that the intervention will determine maternal mental health and child development, as well as positively influence maternal social support and personal problem solving; (2) test the hypothesis that antenatal depression will be a substantial predictor of maternal depression. The results refuted the hypothesis. It was concluded that the intervention did not determine maternal mental health and child development, or positively influence maternal social support and personal problem solving. It was also concluded that antenatal depression was not a substantial predictor of maternal depression at 31/2 years after childbirth.