Maternal depressive symptoms are common during pregnancy and may negatively impact the mother-infant relationship, particularly the development of maternal prenatal representations. This study used a randomised controlled trial to examine whether the interactive ultrasound intervention could improve the quality of prenatal representations of the child among pregnant women with minor depressive symptoms.

Participants (n = 105) were recruited after the routine screening for structural abnormalities between gestational weeks 19 and 21. Prenatal representations were assessed twice during pregnancy, at gestational weeks M = 25 and M = 35, using the Working Model of the Child Interview. Participants were randomly selected either to the intervention group, which received three interactive ultrasound intervention sessions following the protocol, or the control group, receiving standard care. The intervention aimed to support the prenatal mother – infant relationship by facilitating and strengthening pregnant women’s representations of their foetuses, and by increasing maternal involvement and emotional connection with the foetus.

Women in both groups showed high levels of nonbalanced, particularly distorted, representations. For 25% of participants, nonbalanced representations became balanced during the study period. However, the intervention did not improve the quality of representations beyond changes observed in both groups. Especially, balanced prenatal representations remained substantially stable in both groups.

The interactive ultrasound intervention did not have a significant effect. However, the findings provide unique insights into the quality of prenatal representations among women with minor depressive symptoms and highlight the importance of supporting their representational processes during pregnancy.