# Preventing Postpartum Depression: A Dyadic Approach Adjunctive to Obstetric Care

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2022 · $327,065

## Abstract

PROJECT SUMMARY/ABSTRACT
Of the nearly 4 million live births each year in the United States, approximately 560,000, or 14% of these
women will develop depression within the first four months postpartum. The consequences are substantial:
diminished quality of life and significant emotional suffering for women. PPD predicts diminished mother–infant
bonding and poor outcomes in social–emotional and, for some, cognitive development. Relying on standard
pharmacologic and psychological interventions, PPD is undertreated in part because women are reluctant to
seek treatment due to the stigma associated with mental health care, logistical barriers to attending added
health care appointments, and disinclination to take medications while breastfeeding. Risk factors for PPD are
relatively well delineated. Even though prenatal depressive symptoms are some of the most reliable predictors,
evidenced–based, preventive interventions for PPD are rare. Of the preventative interventions, few leverage
the unique dyadic orientation of the childbearing period or imbed services in obstetrical care. To address the
huge knowledge gap in the prevention and treatment of PPD, we developed (R21MH092665–01) and tested in
a preliminary randomized control trial (RCT) a new intervention called PREPP (Practical Resources for
Effective Postpartum Parenting) and, following promising published data, we propose to conduct a larger RCT
of this treatment. PREPP enrolls pregnant women at risk for PPD, spans late pregnancy to the 6– week
postpartum check-up. It consists of four in–person ‘coaching’ sessions adjunctive to obstetrical (OB) prenatal
and postnatal appointments, and one phone session. PREPP includes (a) mindfulness and self– reflection
skills, (b) parenting skills and (c) psycho–education. For this proposed project, we have three study aims to
be realized in a PREPP vs Enhanced Treatment as Usual RCT of 214, 3rd trimester pregnant women (ages
18–35) at risk for PPD assessed 2x in pregnancy and at 6, 12, and 16 weeks postpartum: (1) Reduce women’s
distress during pregnancy (2) Determine the maintenance of improved maternal mood and differences in infant
behavior (3) Identify some of the pathways by which PREPP positively affects the mother– infant dyad. PREPP
is innovative in its novel conceptualization of PPD and design to overcome barriers to PPD treatment. The
traditional clinical approach to PPD has as a focus the individual and improving their symptoms. In PREPP,
PPD is viewed as a potential disorder of the mother–infant dyad, which can be approached through preventive
psychological and behavioral changes in the mother — commencing before birth — that affect her and the
child. PREPP exemplifies the vanguard of health care innovations aiming to increase metal health care uptake
by integrating behavioral health services with primary health care. This administrative supplement seeks
funds to complete the original aims stalled as a consequence of the COVID-19 pandemic.

## Key facts

- **NIH application ID:** 10616235
- **Project number:** 3R01HD092062-05S1
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Catherine E Monk
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $327,065
- **Award type:** 3
- **Project period:** 2022-08-08 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10616235

## Citation

> US National Institutes of Health, RePORTER application 10616235, Preventing Postpartum Depression: A Dyadic Approach Adjunctive to Obstetric Care (3R01HD092062-05S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10616235. Licensed CC0.

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