Mindfulness for Perinatal Distress

• Group Mindfulness Intervention (Behavioral): The intervention consisted of eight weekly 60-minute offline group sessions. Each group included 12 to 20 participants. Sessions covered mindfulness theory, mindful breathing, body scan, mindful eating, sitting meditation, walking meditation, mindful stretching, and group reflection. The intervention was delivered by psychiatrists or psychological counseling professionals trained in mindfulness.
• Group Discussion (Behavioral): Participants attended eight weekly 60-minute offline group discussion sessions. Discussion topics included physical changes during pregnancy, emotional experiences, concerns about childbirth, and adaptation to daily life. The facilitator maintained group order and timing but did not provide structured psychological techniques or professional psychological guidance.
• Routine Health Education (Behavioral): Participants received routine outpatient health education once weekly for 8 weeks. Each session lasted approximately 15 to 20 minutes and covered antenatal health care, precautions for prenatal visits, diet, and rest. No group psychological intervention was provided.

Primary outcomes

• Change in anxiety symptoms [Baseline and immediately after the 8-week intervention]: Self-Rating Anxiety Scale (SAS) Anxiety symptoms were assessed using the 20-item Zung Self-Rating Anxiety Scale (SAS). Each item is rated from 1 to 4. The raw total score ranges from 20 to 80 and is multiplied by 1.25 and rounded to obtain a standard score ranging from 25 to 100. The minimum possible standard score is 25 and the maximum is 100. Higher scores indicate more severe anxiety symptoms. A standard score of 50 or higher indicates the presence of anxiety symptoms. The standard score was used in the analysis.
• Change in depressive symptoms [Baseline and immediately after the 8-week intervention]: Self-Rating Depression Scale (SDS) Depressive symptoms were assessed using the 20-item Zung Self-Rating Depression Scale (SDS). Each item is rated from 1 to 4. The raw total score ranges from 20 to 80 and is multiplied by 1.25 and rounded to obtain a standard score ranging from 25 to 100. The minimum possible standard score is 25 and the maximum is 100. Higher scores indicate more severe depressive symptoms. A standard score of 53 or higher indicates the presence of depressive symptoms. The standard score was used in the analysis.
• Change in fear of childbirth [Baseline and immediately after the 8-week intervention]: Childbirth Attitudes Questionnaire (CAQ) Fear of childbirth was assessed using the 16-item Childbirth Attitudes Questionnaire (CAQ). Each item is rated from 1 to 4, producing a total score ranging from 16 to 64. The minimum possible total score is 16 and the maximum is 64. Higher scores indicate greater fear of childbirth. Scores of 16-27 indicate no fear, 28-39 mild fear, 40-51 moderate fear, and 52-64 severe fear. A total score of 28 or higher indicates the presence of fear of childbirth. The total score was used in the analysis.

Sex: Female, ages: 18 Years to any

Inclusion Criteria:

* Pregnant women at 20 to 30 gestational weeks.
* No obvious pregnancy complications.
* Able to complete questionnaires independently.
* Willing to participate in the study and able to complete the 8-week intervention.
* Provided written informed consent.

Exclusion Criteria:

* Self-harm behavior or suicidal tendency.
* Current psychiatric medication use.
* Severe mental disorder, such as schizophrenia, bipolar disorder, or organic mental disorder.
* Severe somatic disease, such as abnormal liver or renal function, brain injury, heart disease, or epilepsy.
* Pregnancy complications or expected inability to complete the intervention or follow-up.

• Jingchu Hu, Dr., Principal investigator, Shenzhen Kangning Hospital