The effect of a digital intervention on symptoms of depression in pregnant women exposed to intimate partner violence in Denmark and Spain (STOP study)

Abstract

IPV during pregnancy is a significant public health concern associated with adverse maternal and fetal health outcomes, including increased risk of depression. This study aimed to assess the effectiveness of a digital empowerment-based intervention in reducing symptoms of depression among IPV-exposed pregnant women. This intervention study was nested within a cohort study conducted in Denmark and Spain. Pregnant women attending antenatal care were digital screened for IPV using the AAS and the WAST. Those screening positive were offered a digital intervention with trained IPV counsellors and access to a safety planning app. Changes in depression scores from baseline to follow-up were evaluated using mixed model regression. From February 2021-October 2022, 1,545 pregnant women (9.6 %) screened positive for IPV within our population (8.5 % in Denmark and 17.0 % in Spain) with 485 (31.4 %) meeting the criteria for the intervention. Of those eligible, 104 (21.4 %) accepted the intervention, and 55 completed it (13.1 %). Post-intervention, a significant reduction in EPDS scale was found, with a mean difference of −3.9 (95 % CI: −5.3; −2.4), compared to the average pre-intervention score of 11.3. Stratifying the analyses across sociodemographic variables did not alter the overall result, indicating a reduction in EPDS scores irrespective of setting or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off. The findings suggest that a brief digital intervention is associated with a reduction in depression symptoms among pregnant women exposed to IPV, particularly among those with high depressive scores. This highlights the potential of digital interventions in delivering counseling and shows efficacy when administered by both midwives and psychologists in diverse settings. However, the absence of a control group underscores the need for caution in interpreting the results.