Cognitive behavioural stress management during pregnancy

INTERVENTION: All pregnant women were required to undergo 7 antenatal visits in accordance with the "Chinese Guidelines for pre‐pregnancy and prenatal care" from 12 to 41 weeks of their pregnancy. 100 participants were randomly divided into the control group (N=50) and the intervention group (N=50) using a computerized random number generator. The control group received routine antenatal care and pregnancy health education instruction (including advice on diet, fetal monitoring and daily care during pregnancy). Participants in the intervention group underwent an extra 7 cognitive behavioural stress management sessions between weeks 8 and 38 of their pregnancy. The sessions covered information on the physiological and psychological changes in pregnancy, coping methods for pregnancy stress, relaxation techniques, and family support. Following each seminar, the facilitator invited participants to participate in group discussions to share their pregnancy experience, including their problem‐solving strategies. The facilitator recorded the process but did not participate the discussion. At the end of the session the facilitator summarized the results of the group discussion and proposed strategies of reducing pregnancy stress to participants. Additionally, individual counseling was provided if the participants required this.The cognitive behavioral stress management was delivered mainly through face‐to‐face communication in the hospital, but in some cases, it was delivered via phone and e‐mail. The whole process for each intervention lasted 40‐60 minutes. CONDITION: Pregnancy ; Pregnancy and Childbirth ; Pregnancy PRIMARY OUTCOME: Pregnancy stress level, assessed using the Pregnancy Pressure Scale (PPS) at the baseline and after 39 weeks of pregnancy INCLUSION CRITERIA: 1. Pregnant 2. Able to communicate and understand Chinese 3. No severe medical conditions, including heart disease, diabetes and kidney disease 4. Aged 20‐38 years