Citation

Baas MAM, van Pampus MG, Stramrood CAI, Dijksman LM, Vanhommerig JW, De Jongh A. Front. Psychiatry 2022; 12.

Copyright

(Copyright © 2022, Frontiers Media)

DOI

10.3389/fpsyt.2021.798249

PMID

unavailable

Abstract

Fear of childbirth (FoC) occurs in 7. 5% of pregnant women and has been associated with adverse feto-maternal outcomes. Eye Movement Desensitization and Reprocessing (EMDR) therapy has proven to be effective in the treatment of posttraumatic stress disorder (PTSD) and anxiety; however, its effectiveness regarding FoC has not yet been established. The aim was to determine the safety and effectiveness of EMDR therapy for pregnant women with FoC. This single-blind RCT (the OptiMUM-study, www.trialregister.nl, NTR5122) was conducted in the Netherlands. FoC was defined as a score ≥85 on the Wijma Delivery Expectations Questionnaire (WDEQ-A). Pregnant women with FoC and a gestational age between 8 and 20 weeks were randomly assigned to EMDR therapy or care-as-usual (CAU). The severity of FoC was assessed using the WDEQ-A. Safety was indexed as worsening of FoC symptoms, dropout, serious adverse events, or increased suicide risk. We used linear mixed model analyses to compare groups. A total of 141 women were randomized (EMDR n = 70; CAU n = 71). No differences between groups were found regarding safety. Both groups showed a very large (EMDR d = 1.36) or large (CAU d = 0.89) reduction of FoC symptoms with a mean decrease of 25.6 (EMDR) and 17.4 (CAU) points in WDEQ-A sum score. No significant difference between both groups was found (p = 0.83). At posttreatment, 72.4% (EMDR) vs. 59.6% (CAU) no longer met the criteria for FoC. In conclusion, the results are supportive of EMDR therapy as a safe and effective treatment of FoC during pregnancy, albeit without significant beneficial effects of EMDR therapy over and above those of CAU. Therefore, the current study results do not justify implementation of EMDR therapy as an additional treatment in this particular setting. Copyright © 2022 Baas, van Pampus, Stramrood, Dijksman, Vanhommerig and de Jongh.

Language: en

Keywords

adult; human; suicide; female; treatment; randomized controlled trial; patient safety; Netherlands; disease severity; pregnancy; major clinical study; controlled study; single blind procedure; multicenter study; Article; pregnant woman; childbirth; gestational age; clinical effectiveness; EMDR; fetus death; patient dropout; anxiety assessment; eye movement desensitization and reprocessing; low risk patient; immaturity; eye movement desensitization and reprocessing therapy; fear of childbirth; symptom worsening; tocophobia; Wijma Delivery Expectations Questionnaire