• couple relationship;
  • PREP;
  • preventing marital distress;
  • transition to parenthood

The aim of the study was to investigate patterns of self-selection into the Prevention and Relationship Education Program (PREP) as it was offered universally to expectant couples attending maternity services in a Swedish town. The baseline questionnaire was answered by 141 couples, of whom 63% later participated in PREP, and 37% served as a comparison group. The results showed that couples who chose to participate in PREP had a shorter relationship, were more often unmarried first-time parents, and reported lower levels of relationship adjustment. PREP participants also had higher scores of depressive symptoms and poorer self-rated health. It seems that expectant couples are interested in preventive relationship education and that couples with more risk factors for vulnerable relationships self-selected into PREP when the program was offered universally during pregnancy. The selection pattern into PREP has interesting implications for public health interventions and their dissemination.