Interpersonal psychotherapy for adolescent gestational weight gain and wellbeing: pilot and feasibility randomised...

Pregnant adolescents face adversities that heighten perinatal complications in mental (e.g. depression) and physical (e.g. excess gestational weight gain [GWG]) health. Depression may affect excess GWG through stress-related behaviours. We sought to pilot feasibility/acceptability of integrating a brief mental health intervention within prenatal care to address depression and stress-related behaviours contributing to excess GWG.

The current study reports recruitment/retention, feasibility, and intervention/protocol acceptability of a pilot randomised controlled trial with N = 37 pregnant 13-19-year-olds receiving multidisciplinary prenatal care (NCT03086161). Participants were randomised to 6 × 1-hour individual interpersonal psychotherapy sessions plus usual multidisciplinary prenatal care (IPT+UC) or usual care only (UC). Feasibility was tracked using CONSORT flow. Adolescents completed acceptability ratings at post-program. Within-condition and between-group changes in social functioning, depression, stress-related behaviours, and GWG were assessed from baseline to mid-programme and post-programme.

88% of potentially eligible patients enrolled. At mid-programme, 43% were retained in IPT+UC versus 38% in UC; at post-program 38% were retained in IPT+UC versus 35% in UC. Within IPT+UC, 47% received ≥ 80% IPT dosage. Adolescents rated IPT acceptability above-average. Within-group, IPT+UC showed decreased mother-adolescent negative interactions at mid-programme (r = .76, p = .01) and post-programme (r = .63, p = .04). There was no difference in gestational weight gain between arms (ε² = .02, p = .87).

Brief, integrated mental health therapy in multidisciplinary prenatal care for adolescents has feasible enrolment and may offer an acceptable approach for mental-physical health. Dosage and retention require refinement. Incorporating dissemination/implementation science principles is warranted in future tests of IPT to support the mental-physical health of pregnant adolescents.