Mindfulness-based Stress Reduction in Pregnancy: an App-Based Programme to Improve the Health of Mothers and Children (MINDFUL/PMI Study) Achtsamkeitsbasierte Stressreduktion in der Schwangerschaft: ein App-basiertes Programm zur Verbesserung der Gesundheit von Müttern und Kindern (MINDFUL/PMI-Studie) Authors Bernd Lenz 1 *, Anna Eichler 2 *, Eva Schwenke 3 *, Verena N. Buchholz 1 , Charlotte Hartwig 3 , Gunther H. Moll 2 , Karin Reich 1 , Christiane Mühle 1 , Bernhard Volz 3,4 , Adriana Titzmann 3 , Matthias W. Beckmann 3 , Hartmut Heinrich 2, 5 *, Johannes Kornhuber 1 *, Peter A. Fasching 3 * Affiliations 1 Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany 2 Kinder- und Jugendabteilung für Psychische Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany 3 Frauenklinik, Friedrich-Alexander-Universität Erlangen- Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany 4 Biostatistics and Data Management Unit, Frauenklinik des Universitätsklinikums Erlangen, Erlangen, Germany 5 kbo-Heckscher-Klinikum, München, Germany Key words pregnancy, stress, alcohol, tobacco, testosterone, 2D: 4D, index/ring finger length ratio, mindfulness Schlüsselwörter Schwangerschaft, Stress, Alkohol, Tabak, Testosteron, 2D : 4D, Zeige‑/Ringfingerlängenverhältnis, Achtsamkeit received 26. 6. 2018 revised 10. 8. 2018 accepted 10. 8. 2018 Bibliography DOI https://doi.org/10.1055/a-0677-2630 Geburtsh Frauenheilk 2018; 78: 1283–1291 © Georg Thieme Verlag KG Stuttgart · New York | ISSN 0016‑5751 Correspondence PD Dr. med. Bernd Lenz Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen Schwabachanlage 6, 91054 Erlangen, Germany bernd.lenz@uk-erlangen.de Deutsche Version unter: https://doi.org/10.1055/a-0677-2630 ABSTRACT Unfavourable intrauterine environmental factors increase the risk of delivery complications as well as postpartum develop- mental and behavioural problems in children and adolescents with ongoing effects into older age. Biomarker studies show that maternal stress and the use of alcohol and tobacco dur- ing pregnancy are associated with a higher intrauterine tes- tosterone exposure of the child. The antenatal testosterone load, in turn, is a risk factor for lasting adverse health effects which extend into adulthood. A 15-week, mindfulness-orient- ed, app-based programme for the reduction of stress as well as for the reduction of alcohol and tobacco use in pregnant women is established. In the monocentre, prospective, con- trolled, and investigator-blinded MINDFUL/PMI (Maternal Health and Infant Development in the Follow-up after Preg- nancy and a Mindfulness Intervention) study, pregnant wom- en carry out the programme. Its effect on antenatal testoster- one exposure of the child is examined by assessing the index/ ring finger length ratio and other biomarkers in the 1-year-old children. In addition, the programmeʼs effects on self-regula- tion, the developmental status and the mental health of the children at the age of one year will be investigated. Additional aspects of the course of the pregnancy and delivery represent exploratory study objectives. This longitudinal study project is * The authors contributed equally. GebFra Science | Original Article 1283 Lenz B et al. Mindfulness-based Stress Reduction … Geburtsh Frauenheilk 2018; 78: 1283–1291