Evaluating Interventions Through Randomised Controlled Trials
A central focus of PIRI’s research is the development and evaluation of validated interventions that are brief, cost-effective, and readily translated into everyday clinical and community practice.
PIRI has conducted numerous high-quality randomised controlled trials (RCTs) evaluating interventions for antenatal and postnatal depression, including programs that target both maternal mental health and infant developmental outcomes.
PIRI researchers published the first evidence from an RCT demonstrating that treating maternal depression during pregnancy can lead to improved developmental outcomes in children (Milgrom et al., 2015). This work has been extended through follow-up studies in later childhood (Milgrom, Holt, et al., 2019), as well as publications examining genome-wide DNA methylation patterns and structural brain differences in children whose mothers received treatment compared with those who did not (Bleker et al., 2019a; 2019b).
PIRI is currently conducting a large NHMRC-funded RCT, Beating the Blues Before Birth, addressing the impact of antenatal treatment on maternal mental health and child development.
- Stress and Brain Development
- Preterm Infants
- Infancy and Early Relationships
- Tailored Treatments for Specific Populations
- Advancing Screening Practice
Understanding the relationship between early stress and brain development has been a major focus of PIRI’s research. This work has included longitudinal studies in high-risk preterm infants (NHMRC, 2006–2013).
PIRI has also examined stress–brain development pathways in children whose mothers received cognitive behavioural therapy (CBT) for depression during pregnancy (NARSAD, 2016–2017), contributing to evidence that early intervention can influence neurodevelopmental outcomes.
PremieStart, developed by PIRI, is a parent-focused intervention designed to reduce stress experienced by preterm infants during their stay in the Neonatal Intensive Care Unit (NICU).
Landmark studies have demonstrated improvements in infant brain structure and white matter connectivity visible on MRI (Milgrom et al., 2010), as well as positive effects on early infant development (Milgrom et al., 2013) following this stress-reduction intervention.
Primary outcomes from a large NHMRC-funded RCT of PremieStart have been published (Milgrom, Martin, et al., 2019), with further peer-reviewed publications in development. PIRI is currently funded by the Austin Medical Research Fund to conduct a nine-year follow-up examining academic outcomes in children from this cohort.
PIRI’s longstanding research interest in infancy spans early findings demonstrating the protective role of the mother–infant relationship, including its neurophysiological foundations, through to the development of contemporary parent–infant interventions.
Professor Jeannette Milgrom established the Parent-Infant Research Institute in 2001 with a specific focus on infancy research and early intervention.
PIRI has designed and evaluated multiple interventions through high-quality RCTs targeting both maternal mental health and infant outcomes, including stress-reduction approaches for preterm infants. PIRI researchers were among the first to show that even when postnatal depression is effectively treated, associated stress within the parent–infant relationship may persist and continue to influence infant development. One influential study demonstrated links between early interaction difficulties and later cognitive outcomes.
PIRI develops and evaluates perinatal mental health interventions tailored for specific populations, including pregnant and postpartum women, couples, and fathers, delivered across a range of formats such as self-help, distance-based therapy, group, individual, and web-based programs.
PIRI has pioneered preventive and treatment approaches for antenatal depression and anxiety with the aim of protecting later child development. This work reflects PIRI’s strength in designing interventions and conducting RCTs that translate knowledge of mood, behaviour, and relationships into effective, real-world treatments.
A major achievement has been the development of MumMoodBooster, progressed to delivery-ready scale through collaboration with international experts at the Oregon Research Institute. Funded by the US National Institute of Mental Health, MumMoodBooster was developed through a staged, evidence-based process and has demonstrated effectiveness in randomised controlled trials, including direct comparison with face-to-face psychological therapy.
Building on this work, PIRI is developing DadBooster, a world-first, web-based CBT intervention for fathers experiencing perinatal depression or anxiety. This program addresses a critical service gap, as new fathers are less likely to access traditional supports and often remain untreated.
Identifying Perinatal Depression and Anxiety, edited by Professor Jeannette Milgrom and Dr Alan Gemmill, brings together leading international research and clinical expertise on perinatal mental health screening and management.
The book examines evidence-based approaches to screening, psychosocial assessment, diagnosis, and management, drawing on models from Australia, the United Kingdom, and the United States. It critically evaluates the accuracy and limitations of screening tools, considers policy and implementation challenges, and explores pathways to care following identification.
The volume also highlights the importance of including infants and fathers in screening processes, the need for specialised workforce training, and the economic considerations of screening programs. Together, these contributions provide a comprehensive synthesis of current knowledge and identify priorities for future research and practice.