Abstract

Objective: To assesses the effectiveness of a digital intervention for pregnant women exposed to Intimate Partner Violence (IPV) in reducing symptoms of depression

Design: Intervention study nested in a cohort study

Setting: Denmark and Spain

Population: Pregnant women attending antenatal care

Methods: Routine digital IPV screening was conducted during antenatal care using the AAS and WAST screening tools. Pregnant women who screened positive were offered a digital intervention in the form of 3-6 video consultations with trained IPV counselors and access to a safety planning app. Changes in depression scores from baseline to follow-up were assessed using linear mixed regression. 

Main Outcome Measure: Symptoms of depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS).

Results: From February 2021 to October 2022, 1,545 pregnant women (9.6%) screened positive for IPV (8.5% in Denmark and 17.0% in Spain). Of 485 women (31.4%) eligible, 104 (21.4%) accepted the intervention, and 55 completed it (52.9%). The intervention significantly reduced symptoms of depression with a mean difference of -3.9 (95% CI: -5.3; -2.4) in EPDS scores pre- versus post-intervention. Stratified analyses across sociodemographic variables did not affect the overall result, indicating a reduction in EPDS scores regardless of location or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off. 

Conclusion:  Video consultations and access to a safety planning app is associated with a reduction in depression scores among pregnant women exposed to partner violence, particularly among those with high depressive scores. 

Karen Andreasen, Rodrigo Fernandez-Lopez, Chunsen Wu, Ditte S Linde, Alba Oviedo-Gutiérrez, Jesús L Megías, Stella Martín-de-las-Heras, Antonella L Zapata-Calvente, Lea Ankerstjerne, Sabina de-León-de-León, Sarah Dokkedahl, Berit Schei, Vibeke Rasch.

Keywords: Intimate partner violence; domestic violence; telemedicine; mHealth; depression; mental health; antenatal care