Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial
Abstract Background Perinatal depression is associated with poor outcomes related to HIV care adherence, maternal functioning, and early child development. We examined whether the M-DEPTH (Maternal Depression Treatment in HIV) depression care model—including antidepressant therapy and individual pro...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-025-07443-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849732831469633536 |
|---|---|
| author | Glenn J. Wagner Bonnie Ghosh-Dastidar Violet Gwokyalya Laura J. Faherty Jolly Beyeza-Kashesya Juliet Nakku Linda Kisaakye Nabitaka Dickens Akena Janet Nakigudde Victoria Ngo Ryan McBain Hafsa Lukwata Leticia Kyohangirwe Barbara Mukasa Rhoda K. Wanyenze |
| author_facet | Glenn J. Wagner Bonnie Ghosh-Dastidar Violet Gwokyalya Laura J. Faherty Jolly Beyeza-Kashesya Juliet Nakku Linda Kisaakye Nabitaka Dickens Akena Janet Nakigudde Victoria Ngo Ryan McBain Hafsa Lukwata Leticia Kyohangirwe Barbara Mukasa Rhoda K. Wanyenze |
| author_sort | Glenn J. Wagner |
| collection | DOAJ |
| description | Abstract Background Perinatal depression is associated with poor outcomes related to HIV care adherence, maternal functioning, and early child development. We examined whether the M-DEPTH (Maternal Depression Treatment in HIV) depression care model—including antidepressant therapy and individual problem-solving therapy—and depression alleviation would affect improvement in each of these outcome domains. Methods A sample of 354 pregnant women living with HIV (WLH) with at least mild depressive symptoms (177 in each of intervention and usual care control arms) enrolled in a cluster randomized controlled trial across eight antenatal care clinics in Uganda and had a live birth delivery. Longitudinal mixed effects models were used to examine survey data and chart-abstracted HIV viral load and antiretroviral pharmacy refill data collected at baseline and months 2, 6, 12 and 18 post-partum. Results 69% had clinical depression at enrollment; 70% of women in the intervention group (including 96% of those with clinical depression) received depression treatment. Mixed-effects longitudinal regression analysis showed (1) strong effects of the intervention on maternal depression at each post-partum follow-up assessment; and (2) moderate effects of the intervention and reduced depression on maternal functioning (self-care and infant care, in particular). However, there was little evidence of effects of the intervention and depression reduction on early child development, maternal viral suppression, or ART adherence. Conclusion These findings suggest that depression care for pregnant WLH is important for maternal mental health, but it also helps women to better manage parenting and care for their infant. Supplementary interventions may be needed to impact early child development. Trial registration The trial was registered with the NIH Clinical Trial Registry (clinicaltrials.gov: NCT03892915) on 27/03/2019. |
| format | Article |
| id | doaj-art-aff2bf6c063d4ef6b77a53910c0e7a02 |
| institution | DOAJ |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-aff2bf6c063d4ef6b77a53910c0e7a022025-08-20T03:08:12ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-0125111210.1186/s12884-025-07443-0Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trialGlenn J. Wagner0Bonnie Ghosh-Dastidar1Violet Gwokyalya2Laura J. Faherty3Jolly Beyeza-Kashesya4Juliet Nakku5Linda Kisaakye Nabitaka6Dickens Akena7Janet Nakigudde8Victoria Ngo9Ryan McBain10Hafsa Lukwata11Leticia Kyohangirwe12Barbara Mukasa13Rhoda K. Wanyenze14RAND CorporationRAND CorporationSchool of Public Health, Makerere UniversityRAND CorporationMulago Specialized Women and Neonatal HospitalButabika National Referral Mental HospitalMinistry of HealthCollege of Health Sciences, Makerere UniversityCollege of Health Sciences, Makerere UniversityRAND CorporationRAND CorporationMinistry of HealthButabika National Referral Mental HospitalMildmay UgandaSchool of Public Health, Makerere UniversityAbstract Background Perinatal depression is associated with poor outcomes related to HIV care adherence, maternal functioning, and early child development. We examined whether the M-DEPTH (Maternal Depression Treatment in HIV) depression care model—including antidepressant therapy and individual problem-solving therapy—and depression alleviation would affect improvement in each of these outcome domains. Methods A sample of 354 pregnant women living with HIV (WLH) with at least mild depressive symptoms (177 in each of intervention and usual care control arms) enrolled in a cluster randomized controlled trial across eight antenatal care clinics in Uganda and had a live birth delivery. Longitudinal mixed effects models were used to examine survey data and chart-abstracted HIV viral load and antiretroviral pharmacy refill data collected at baseline and months 2, 6, 12 and 18 post-partum. Results 69% had clinical depression at enrollment; 70% of women in the intervention group (including 96% of those with clinical depression) received depression treatment. Mixed-effects longitudinal regression analysis showed (1) strong effects of the intervention on maternal depression at each post-partum follow-up assessment; and (2) moderate effects of the intervention and reduced depression on maternal functioning (self-care and infant care, in particular). However, there was little evidence of effects of the intervention and depression reduction on early child development, maternal viral suppression, or ART adherence. Conclusion These findings suggest that depression care for pregnant WLH is important for maternal mental health, but it also helps women to better manage parenting and care for their infant. Supplementary interventions may be needed to impact early child development. Trial registration The trial was registered with the NIH Clinical Trial Registry (clinicaltrials.gov: NCT03892915) on 27/03/2019.https://doi.org/10.1186/s12884-025-07443-0DepressionHIVProblem solving therapyAntidepressant therapyMaternal functioningChild development |
| spellingShingle | Glenn J. Wagner Bonnie Ghosh-Dastidar Violet Gwokyalya Laura J. Faherty Jolly Beyeza-Kashesya Juliet Nakku Linda Kisaakye Nabitaka Dickens Akena Janet Nakigudde Victoria Ngo Ryan McBain Hafsa Lukwata Leticia Kyohangirwe Barbara Mukasa Rhoda K. Wanyenze Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial BMC Pregnancy and Childbirth Depression HIV Problem solving therapy Antidepressant therapy Maternal functioning Child development |
| title | Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial |
| title_full | Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial |
| title_fullStr | Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial |
| title_full_unstemmed | Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial |
| title_short | Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial |
| title_sort | effects of m depth model of depression care on maternal depression functioning and hiv care adherence and infant developmental over eighteen months post partum results from a cluster randomized controlled trial |
| topic | Depression HIV Problem solving therapy Antidepressant therapy Maternal functioning Child development |
| url | https://doi.org/10.1186/s12884-025-07443-0 |
| work_keys_str_mv | AT glennjwagner effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT bonnieghoshdastidar effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT violetgwokyalya effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT laurajfaherty effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT jollybeyezakashesya effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT julietnakku effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT lindakisaakyenabitaka effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT dickensakena effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT janetnakigudde effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT victoriango effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT ryanmcbain effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT hafsalukwata effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT leticiakyohangirwe effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT barbaramukasa effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial AT rhodakwanyenze effectsofmdepthmodelofdepressioncareonmaternaldepressionfunctioningandhivcareadherenceandinfantdevelopmentalovereighteenmonthspostpartumresultsfromaclusterrandomizedcontrolledtrial |