Digital Cognitive Behavioral Therapy: A Novel Approach to Support High Risk Pregnant Women

Abhishek Shah, Dr. Sneha Damse ,Dr. Premalatha.T, Karine Soulat, Keshavi Khanna, 

¹Wellthy Therapeutics Pvt Ltd, Mumbai, India. 

Objective: This study explores the real-world effectiveness of Wellthy CARE digital therapeutic (WDTx) platform in maintaining mental wellbeing of high-risk pregnant women through CBT therapy.Threatened Miscarriage(TM) and Recurrent pregnancy loss(RPL) are one of the most frustrating and difficult areas of reproductive medicine which may have a significant psychological impact on women¹.  The expectant mother goes through a variety of emotional and psychological experiences during a high-risk pregnancy that may be associated with  adverse pregnancy outcomes.² 

Design:Non randomized controlled trial (9 months)

Methods:

This  study included a patient support program delivered by a multidisciplinary team of health professionals through the WDTx platform . The program included interventions such as Health coach chats and calls, Lifestyle counseling, CBT counseling, Symptom tracking and in-app educational content. .The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS)³was used to assess psychological functioning and subjective well being. 40 pregnant women diagnosed with RPL and TM who were stable and willing to participate were recruited by convenience sampling method.The participants were divided into  two cohorts of 20 each .One cohort received CBT therapy while others received standard treatment and educational contents.  

Results:

The mean age of participants was 29.09. Independent samples T test confirmed that patients who underwent  psychological counseling had statistically significant higher scores(31.20±2.50) than patients who did not undergo psychological counseling  (26.25 ± 5.03), p=0. 001. Both cohorts on WDTx scored higher than UK general population samples (23.5 ± 3.9)4. The results of “Pearson Chi-Square” indicated statistically significant association between scores and total number of calls χ (1) = 834.57, p = 0.048. Our analysis showed that the higher the interactions ,the better the scores of mental wellbeing. 67.5% of the participants delivered successfully and 32.5% are expected to deliver in future. 

Conclusion:

The results of this study indicate that psychological counseling delivered via a digital platform, can play a significant role in impacting maternal mental well-being. Improvement in mental well being has been shown to positively influence adherence and practice of recommended maternal health behaviors and contribute to successful delivery outcomes.These risk factors should be taken into consideration for  Antenatal surveillance and management of pregnancy. Digital Therapeutics (DTx) has  a potential role in addressing this need by providing 24/7 access to tools and resources at patient’s  fingertips to help them better manage their disease in-between medical appointments.

Keywords: Short Warwick-Edinburgh Mental Well-being Scale, RPL TM