Impact of the World Health Organization's Thinking Healthy Program (THP) on Maternal Depression, Lifestyle, and Delivery Method: An interventional Study in Iran

Abstract Background:Maternal depression during pregnancy and the postnatal period can have significant implications for both the mother and child. The Thinking Healthy Program (THP) has shown promise in addressing perinatal depression, but its impact on maternal well-being, delivery mode, and lifestyle in the Iranian context remains understudied. Methods: This interventional study included 80 pregnant women in Tehran, Iran, divided into intervention and control groups. Depression levels were assessed using the Edinburgh and Beck questionnaires, with the intervention group receiving THP from health liaisons and the control group receiving routine care. The THP intervention comprised four modules conducted from the second trimester of pregnancy to six months post-delivery. Depression scores were evaluated at various time points, and delivery mode and health-promoting lifestyle were documented. Results: At the end of pregnancy (first module), Edinburgh scores were 12.3±2.2 vs.15.81±2, and the Beck scores were 19±4 vs. 20±4 in the intervention and control groups respectively. At the end of the study, 6 months after birth, Beck scores were 9±4.3 vs. 10.6±3.3 in the intervention and control groups, respectively (all P-values<0.001). At all end points, depression scores were more improved in the intervention group. The lifestyle score at the end of the study was significantly higher in the intervention group (151±17 vs. 107±12) (P<0.001). Also, elective caesarean section was significantly lower in the intervention group (10% vs. 57.5%) (P-value: 0.001). Discution: The implementation of THP in this study led to improved maternal well-being, as evidenced by reduced depression symptoms, positive impacts on lifestyle, and a lower rate of elective caesarean sections. Conclusion: These findings suggest the feasibility and benefits of integrating THP into the Iranian healthcare system to support pregnant women with depression and enhance maternal and child health outcomes.