Appropriateness of the intervention
depression, anxiety
HAND INFECTION, RECRUITMENT, EARLY PREGNANCY, DISORDERS
There was only one dropout each in the intervention and control groups, and there was no voluntary discontinuation. In addition, there were no cases in which anxiety was significantly enhanced by the program, and both anxiety and depression scores were lower in the intervention group in terms of outcome. It may be possible for trained midwives to provide a CBT program to pregnant women who are at risk for anxiety disorders but that do not meet the threshold for formal diagnosis.CBT is generally given weekly or biweekly as a treatment. The mean number of gestational weeks at recruitment in this study was 29 weeks, with few dropouts. As the sessions were completed at around 35 weeks, approximately 30 weeks seems an appropriate time to initiate CBT.This study was conducted remotely because of measures implemented to mitigate the COVID-19 pandemic. In a situation where face masks were required to be worn, conducting remote sessions made it possible to remove face masks, which offered the advantage of being able to see facial expressions. Remote sessions for CBT delivery may be valuable going forward and will allow confirmation of facial expressions and conditions, while also permitting easy access and infection control. Digital therapy is evolving, and i-CBT has been reported to be effective [No participants withdrew from this study and participants’ satisfaction was high. Professional advice on problems encountered during the course of pregnancy and other issues can reduce anxiety, and it is highly significant that midwives, who are in regular contact with women from early pregnancy to postpartum, continue to provide care.In addition, there was no evidence of deterioration in mental status, which showed that the intervention was not harmful. CBT has an infinitesimally low potential to cause harm, and its validation is highly significant.