Nurse-Led Mind–Body Intervention and Its Biobehavioral Effects on Postpartum Mental Health: A Randomized Controlled Trial

Abstract

Background: Postpartum depression (PPD) affects 10–20% of mothers with significant consequences for maternal-infant dyads. HPA axis dysregulation represents a key neurobiological mechanism. Non-pharmacological interventions are often preferred by breastfeeding mothers. Objective: To evaluate a nurse-led mind-body intervention on biobehavioral outcomes (depressive symptoms and cortisol) among primiparous mothers with elevated PPD risk. Methods: Single-center parallel-group RCT with 1:1 allocation and assessor-blinded evaluation. Ninety primiparous mothers (aged 18–40) with EPDS 10–19 at 2 weeks postpartum. Mind-body group (n=45): Eight 90-minute weekly sessions combining mindfulness, slow breathing (6/min), yoga, and loving-kindness. Control (n=45): Standard postpartum care. Results: 84 participants (93.3%) completed follow-up. EPDS: 14.2→7.4 (mind-body) vs 14.5→11.8 (control); between-group difference −4.1 points (95% CI: −5.8 to −2.4; d=1.12; p<.001). Cortisol: 18.5→12.4 vs 18.2→16.5 nmol/L (d=0.89; p<.001). Cortisol mediated 28.4% of EPDS improvement (partial mediation). Remission: 82.2% vs 37.8% (NNT=2.3). Depression history was associated with larger effects (d=1.45; interaction p=.024). Conclusions: Nurse-led mind-body intervention produced clinically significant biobehavioral effects, with EPDS reductions within ranges reported for pharmacotherapy, supporting consideration as a first-line intervention option for at-risk postpartum mothers.