Prenatal VR training helped against postpartum depression only in women with a prior birth

A five-week training program for pregnant women, using computer and virtual reality exercises, may lower the risk of postpartum depression, but in a Danish trial the benefit was significant only among women who had given birth before. The results were presented at the European College of Neuropsychopharmacology (ECNP) Congress in Munich.

Across everyone in the trial, women who trained did better than those who did not, but the difference was not statistically significant. The researchers themselves describe the findings as indicative rather than proof.

Practicing for a baby that has not arrived

The trial, called PACT (prenatal affective cognitive training), enrolled 147 pregnant women from the Copenhagen area who were judged to be at higher risk of postpartum depression. Each was assigned either to the training or to usual care. Follow-up data were available for 121 women: 54 who trained and 67 who did not.

The sessions taught expectant mothers to notice and interpret emotional cues from babies, then had them rehearse different ways of responding in difficult situations before those situations happened. According to ECNP, postpartum depression affects around 1 in 7 women after birth and is separate from the short-lived "baby blues" in the first days.

The result nobody expected

Among women who had previously given birth, the training made a clear difference: 5.3% developed postpartum depression, compared with 34.6% of women who did not receive the training, according to the release. Study author Anne Juul Bjertrup of the NEAD Centre in Copenhagen said the team did not expect this.

Her suggested explanation is that the exercises asked women to imagine their future baby and how they would interact with it. Women who had already had a child may have had a more concrete picture to work with. The release does not give the number of women in this subgroup.

Bjertrup said the results raise the possibility that prevention works differently in first and later pregnancies, and that larger trials are needed to confirm the subgroup effect and work out which parts of the training matter.

Why it is still early

The findings come from a congress presentation, and the overall result missed significance, so the headline effect rests on a subgroup. Bjertrup cautioned that postpartum depression has no single cause and is shaped by biological and psychosocial factors.

Benedetta Vai, a psychiatrist at Università Vita-Salute San Raffaele who was not part of the study, called it encouraging. She noted that women who already have a child may carry difficult experiences from an earlier pregnancy and must tune in to a newborn with a toddler at home. She also said larger trials should measure the mother and baby relationship directly.

The next step, according to the team, is a bigger trial designed to test whether the effect in women with previous births holds up.