Background This study aimed to investigate the efficacy of Happiness Pregnant Birth Parenting (HPBP) in preventing perinatal depression and reducing perceived anxiety and fear in Chinese pregnant women. Methods Women experiencing first-time pregnancy (n = 104) were randomly allocated to the HPBP group or a parallel control treatment group; We collected data at baseline (T0), post-intervention (T1), three days after delivery (T2), and 42 days after delivery (T3). Participants completed questionnaires regarding depressive symptoms, perceived anxiety, fear, satisfaction with life, and five facets of mindfulness. We analyzed differences between the two groups and changes within the same group at the four time points using repeated-measures ANOVA. Results Compared to the active control treatment group, the HPBP group reported lower levels of perceived depressive symptoms at T2 (p < .05, d = 1.83) and T3 (p = .01, d = 2.21); significantly reduced anxiety at T1 (p = .001, d = 5.31) and T2 (p = .003, d = 6.12); significantly reduced fear at T1 (p < .01, d = 14.95) and T2 (p = .04, d = 10.95); and significantly increased life satisfaction at T1 (p < .01, d = 3.86) and T3 (p = .015, d = 3.1) and self-reported mindfulness at T1 (p = .01, d = 6.81) and T2 (p < .01, d = 8.7). Conclusions The findings indicate that the HPBP intervention based on mindfulness effectively decreases the risk of perinatal depression, anxiety, and fear. Thus, this research enhances our knowledge of effective intervention strategies to promote mental well-being and prevent perinatal depression or other negative mental states among pregnant women. Trial registration :Chinese Clinical Trial Registry (ChiCTR):ChiCTR2000033149; The date of first registration is 24/ 05/ 2020.

IntroductionIn the past two decades, mindfulness-based intervention programs have gradually become popular.Many studies have confirmed that these programs can effectively alleviate prenatal stress and negative emotion.The mindfulness-based stress-buffering hypothesis suggests that mindfulness training can induce changes in the levels of the cortisol secreted by the HPA axis, thereby reducing stress susceptibility. However, to date, only a few high-quality evidence-based medical studies have analyzed the effect of the mindfulness-based intervention in a maternal population.Thus, this study investigated the effects of a mindfulness-based psychosomatic intervention on pregnancy stress and the HYPERLINK “javascript:;” hypothalamic-pituitary-adrenal (HPA) axis of pregnant Chinese women.MethodsWomen experiencing first-time pregnancy (n = 117) were randomly allocated to the intervention group or parallel active control group, and data were collected at baseline and post-intervention periods. The participants completed questionnaires regarding mindfulness and pregnancy stress. Saliva samples was collected at the time of waking up, and 30, 45, and 60 min after waking up for analyzing the salivary cortisol levels. We analyzed differences between the two groups and changes within the same group before and after the intervention.Results and discussionA total of 95 participants completed the trial. Compared with the parallel active control group, the intervention group exhibited lower levels of stress after the intervention (P = 0.047). For HPA-axis-related indicators after the intervention, Delta value (P = 0.01) and AUCM value (P = 0.031) of the intervention group were significantly higher than that of the control group. Mindfulness-based interventions effectively reduced the level of pregnancy stress and adjusted the HPA axis function in pregnant women in China.Clinical Trial Registrationhttps://www.chictr.org.cn, identifier ChiCTR 2000033149.