Exploring shared and unique benefits of passive and active prenatal intervention protocols on maternal well-being and neonatal outcomes: A combined qualiquantitative approach

Martina Arioli ^1* Alessandra Consales ² Melissa Savoldi ³ Maria Lorella Gianni ^2,4 Lorenzo Colombo ⁴ Niccolò Giovannini ⁵ Chiara Sacchi ^6* Viola Macchi Cassia ³

• ¹ Department of Psychology, University of Milano-Bicocca, Milan, Italy
• ² Department of Clinical Sciences and Community Health, Dipartimento di Eccellenza 2023-2027, University of Milan, Milan, Italy
• ³ Department of Psychology, University of Milan-Bicocca, Milano, Lombardy, Italy
• ⁴ NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
• ⁵ Department of Obstetrics and Gynecology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
• ⁶ Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Veneto, Italy

In the present study, the shared and distinct effects of two novel prenatal intervention protocols implemented during the last trimester of gestation on perinatal maternal well-being and perinatal outcomes were explored. A total of 250 pregnant women at 28 weeks gestation were randomly assigned to either a Passive relaxation-based Protocol or an Active Protocol involving active maternal engagement in various motor activities during music listening.Anxiety and depression symptoms and attachment to the foetus/infant were assessed through self-report questionnaires before (t0) and after (t1) the protocol, as well 1.5 months postpartum (t2). Qualitative data on participants' emotional experiences while performing the activities were collected through weekly diaries, together with adherence to the intervention protocol and the amount of engagement with the prescribed activities. Group-level analyses showed that both protocols were associated with improvements in anxiety symptoms and attachment to the foetus/infant that extended to the postpartum period, while a different picture emerged for depression symptoms. Analyses of the data collected through the diaries revealed a more nuanced picture, showing that, within each group, maternal well-being outcomes and/or emotional experiences during the protocol were modulated by participants' adherence and engagement with the prescribed activities. No differences between the two intervention groups were found in terms of the perinatal outcomes considered, but the number of relaxation sessions positively predicted newborns' gestational age. These findings offer valuable insights into the mechanisms underlying the effects of passive versus active prenatal interventions, and point to the importance of tailoring intervention strategies based on individual preferences and perinatal stage.