A multi-component psychosocial intervention programme to reduce psychological distress and enhance social support for women undergoing termination of pregnancy for foetal anomaly in China: A randomised controlled trial.

BACKGROUND

Termination of pregnancy for foetal anomaly causes significant psychological distress, yet evidence-based psychosocial interventions tailored to the needs of women experiencing termination of pregnancy for foetal anomalyremain limited.

OBJECTIVE

To evaluate the effectiveness of a multi-component psychosocial intervention designed to reduce depression and post-traumatic stress disorder (PTSD) and enhance psychological flexibility and social support among women following termination of pregnancy for foetal anomaly.

METHODS

A single-blinded, two-arm randomised controlled trial was conducted in two maternity hospitals in Hunan Province, China. Eighty-six participants were randomly allocated to the multi-component psychosocial intervention group (n = 41) or the control group (n = 45). The multi-component psychosocial intervention included informational support, Acceptance and Commitment Therapy, and social support involving an online peer support group and family engagement. Depression, PTSD, psychological flexibility and social support were assessed at baseline, immediately (T1), one-month (T2) and three-months (T3) post-intervention.

RESULTS

Although the intervention group showed greater reductions in depressive symptoms (EPDS: β = 0.92, 95 % CI: -1.38 to 3.21, p = 0.435) and post-traumatic stress symptoms (IES-R: β = 5.31, 95 % CI: -1.25 to 11.86, p = 0.113) compared to the control group, these differences did not reach statistical significance. Significant group-by-time effects emerged for PTSD-related avoidance symptoms (β = 2.98, 95 % CI: 0.27 to 5.70, p = 0.031; d = 0.49), perceived social support (β = -1.56, 95 % CI: -3.10 to -0.02, p = 0.047; d = 0.38) and utilisation of social support (-0.83, 95 % CI: -1.48 to -0.18, p = 0.013; d = 0.55) at T3. Participants with baseline EPDS > 9 (n = 54) showed stronger effects, with significant improvements in depression (β = 2.02, 95 % CI: 0.38 to 3.66, p = 0.016) and experiential avoidance (β = 2.54, 95 % CI: 0.30 to 4.78; p = 0.026) at T1, PTSD (β = 11.75, 95 % CI: 2.39 to 21.12, p = 0.014; d = 0.61) and utilisation of social support (β = -0.95, 95 % CI: -1.85 to -0.04; p = 0.040, d = 0.65) at T3. No adverse events occurred.

CONCLUSIONS

The multi-component psychosocial intervention programme reduced PTSD-related avoidance symptoms and enhanced social support. Participants with depressive symptoms experienced immediate improvements in depression and psychological flexibility, with sustained benefits in PTSD and utilisation of social support over three months. Tailoring the intervention components to individual needs may benefit women undergoing termination of pregnancy for foetal anomaly. Further research should compare women with and without baseline psychological distress to determine who benefits most from this intervention.

TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2100047195.