A self-led digital therapy may help prevent mild anxiety from worsening during pregnancy and after birth, according to a randomized clinical trial led by King’s College London. The RELAX study found that participants who used the online program had lower levels of pre- and post-birth anxiety than those who received usual care, alongside reductions in depression and repetitive negative thinking.
What the RELAX trial tested
The trial, published in JAMA Network Open, evaluated whether adding RELAX to usual maternity care could stop anxiety from increasing among pregnant people who already had elevated repetitive negative thinking and up to moderate anxiety. Usual care in the study included maternity services monitoring, possible contact from a health visitor, and information on self-referral to psychological services.
In total, 268 participants took part, with 134 allocated to RELAX plus usual care. The digital intervention consisted of 12 brief online sessions completed over four weeks on a laptop or tablet, and the sessions used scenarios designed to challenge worry and rumination in everyday and pregnancy-related situations. Participants were between 16 and 28 weeks’ gestation, over 18, and had no current psychiatric diagnosis or suicide risk.
Why the findings matter for maternal mental health
Researchers said the approach is notable because it was the first time this type of digital therapy had been tested specifically to prevent low levels of anxiety from escalating during pregnancy. The study also reported that 81.3% of participants in the RELAX group completed at least 10 of the 12 sessions, suggesting the intervention was acceptable to many users.
Professor Colette Hirsch of King’s College London said the therapy targets repetitive negative thinking, which she described as a pattern that can predict and maintain anxiety. She said the results suggest a digital approach could be integrated into maternity care to reach large numbers of people who may not have a diagnosis or access to mental health support.
From trial to possible service use
The study was funded by the UKRI Medical Research Council and the National Institute for Health and Care Research and delivered through the NIHR Biomedical Research Centre: Maudsley. According to the researchers, RELAX is now being developed into an app called LENS4Pregnancy, with plans being shaped alongside people with lived experience, clinicians, policymakers, charities and health service providers.
With anxiety disorders affecting one in five pregnant women or birthing people, the trial adds to growing interest in scalable digital tools that could support maternal wellbeing earlier, before symptoms become more severe. If further work confirms the findings, the approach could offer a practical option for maternity services looking to expand psychological support without relying solely on in-person care.
Source: News-Medical report on the RELAX trial
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