Pragmatic Parental Support to Mitigate Burnout Among Pregnant and Postpartum Trainees: A Randomized Clinical Trial.

Childbearing physicians in training are at high risk due to stigma, low workplace support, and physical challenges compounding role transitions and increased home responsibilities, yet evaluations of mitigation strategies remain scarce.

培训中的生育期医生由于污名化、工作场所支持不足以及身体挑战加剧角色转变和增加的家庭责任，面临高风险，然而对于缓解策略的评估仍然稀缺。

Background

To assess the efficacy of a parental support package targeting perinatal stressors in reducing burnout and distress among childbearing physicians in training.

评估针对围产期压力源的父母支持包在减少生育期医生培训中的倦怠和压力方面的有效性。

DESIGN, SETTING, AND PARTICIPANTS: Pragmatic, randomized, controlled, parallel-group clinical trial. Pregnant (≥12 weeks' gestation) residents and fellows were enrolled across 7 training institutions in the northeastern US from May 2023 to July 2024.

设计、环境和参与者：实用的、随机的、对照的、平行组临床试验。从2023年5月到2024年7月，在美国东北部的7个培训机构中，招募了孕周≥12周的住院医师和研究生。

Nonbirthing parents were excluded.

排除了非生育父母。

Follow-up concluded in May 2025.

随访截止于2025年5月。

Methods

Participants were randomized 1:1, stratified by site and specialty type (procedural vs nonprocedural), to receive a parental support package (n = 78) or usual support (n = 78) from early pregnancy through 24 weeks post partum.

参与者按照1:1的比例随机分配，根据地点和专业类型（程序性与非程序性）进行分层，接受父母支持包（n = 78）或常规支持（n = 78），从早期妊娠到产后24周。

The parental support package included a smart bassinet, wearable breast pump, virtual perinatal support, and formal faculty mentorship.

父母支持包包括智能婴儿床、可穿戴式电动吸奶器、虚拟围产期支持和正式的教师指导。

main_outcomes_and_measures

The primary outcome was change in burnout (Stanford Professional Fulfillment Index; score range, 0-10; and the emotional exhaustion and interpersonal disengagement subscales), from enrollment during pregnancy to 24 weeks post partum.

主要结果是职业倦怠感（斯坦福职业满足度指数；得分范围，0-10；以及情感耗竭和人际脱离子量表）的变化，从怀孕期间的登记到产后24周。

Secondary outcomes included changes in professional fulfillment, organizational and personal values alignment, relationship strain, career dissatisfaction, and sleep-related impairment.

次要结果包括职业满足感、组织和个人价值观的一致性、关系紧张、职业不满和与睡眠相关损害的变化。

Mixed-effects models analyzed outcomes.

混合效应模型分析了结果。

Effect sizes were standardized using the Cohen d (0.2: small; 0.5: medium; 0.8: large).

效应量使用Cohen d进行了标准化（0.2：小效应；0.5：中等效应；0.8：大效应）。

Results

Of 156 randomized participants, 143 were included in the primary analysis (median age, 32 [IQR, 31-34] years; 71 in the parental support package group and 72 in the usual support group).

在156名随机分配的参与者中，有143名被纳入主要分析（中位年龄为32岁，四分位数间距为31-34岁；71名在父母支持包组，72名在常规支持组）。

From enrollment during pregnancy to 24 weeks post partum, mean burnout scores increased from 2.96 to 3.03 in the parental support package group and from 3.13 to 3.79 in the usual support group (adjusted between-group difference in change, -0.58; 95% CI, -1.10 to -0.07; P = .03; d = 0.65).

从怀孕期间的登记到产后24周，父母支持包组的平均倦怠得分从2.96增加到3.03，而常规支持组的平均倦怠得分从3.13增加到3.79（调整后组间差异变化为-0.58；95%置信区间为-1.10至-0.07；P = .03；效应量为0.65）。

Differences were driven by interpersonal disengagement (adjusted between-group difference in change, -0.70; 95% CI, -1.24 to -0.15; P = .01; d = 0.57).

差异主要由人际脱节驱动（调整后组间变化的差异为-0.70；95%置信区间为-1.24至-0.15；P = .01；效应量d = 0.57）。

Emotional exhaustion scores were not statistically different between groups.

两组间的情绪耗竭评分在统计学上没有显著差异。

conclusions_and_relevance

Among childbearing physicians in training, a parental support package significantly mitigated postpartum burnout.

在培训中的育龄医生中，一项家长支持包显著减轻了产后倦怠。

trial_registration

ClinicalTrials.gov Identifier: NCT06014892.

ClinicalTrials.gov 注册号：NCT06014892。