Antenatal interventions to reduce maternal distress: a systematic review and meta-analysis of randomised trials

Fontein-Kuipers, Y.J.; Nieuwenhuijze, M.J.; Ausems, M.; Bud�, L.; de Vries, R.

Abstract

Background: Maternal distress can have adverse health outcomes
for mothers and their children. Antenatal interventions may reduce maternal distress.

Objective: To assess the effectiveness of antenatal interventions for the reduction of maternal distress during pregnancy and for up to 1 year postpartum.

Search strategy: EBSCO, Medline, PubMed, Cochrane, secondary
references of Cochrane reviews and review articles, and experts in
the field.

Selection criteria: Randomised controlled trials in which the association between an antenatal intervention and the reduction of maternal distress was reported.

Data collection and analysis: Two authors independently abstracted data from each trial. A random-effects meta-analysis assessed the reduction of maternal distress associated with antenatal preventive and treatment interventions, compared with routine antenatal care or another intervention.

Main results: Ten trials with 3167 participants met the inclusion criteria, and nine trials (n = 3063) provided data for the meta-analysis of six preventive interventions and three treatment interventions. The preventive interventions indicated no beneficial reduction of maternal distress (six trials; n = 2793; standardised mean difference, SMD –0.06; 95% confidence interval, 95% CI
0.14–0.01). The treatment interventions indicated a significant effect for the reduction of maternal distress (three trials; n = 270; SMD –0.29; 95% CI –0.54 to –0.04). A sample of women, selected retrospectively, who were more vulnerable for developing maternal distress showed a significant reduction of maternal distress after the interventions (three trials; n = 1410; SMD –0.25; 95% CI – 0.37 to –0.14).

Author’s conclusions: Preventive antenatal interventions for maternal distress show no effect. Antenatal interventions for women who have maternal distress or are at risk for developing maternal distress are associated with a small reduction in maternal distress.

Citation

Fontein-Kuipers, Y., Nieuwenhuijze, M., Ausems, M., Budé, L., & de Vries, R. (2014). Antenatal interventions to reduce maternal distress: a systematic review and meta-analysis of randomised trials. BJOG: An International Journal of Obstetrics and Gynaecology, 121(4), 389-397. https://doi.org/10.1111/1471-0528.12500

• Journal Article Type: Article
• Acceptance Date: Sep 26, 2013
• Online Publication Date: Jan 8, 2014
• Publication Date: 2014-03
• Deposit Date: Jan 10, 2022
• Journal: BJOG: An International Journal of Obstetrics & Gynaecology
• Print ISSN: 1470-0328
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 121
• Issue: 4
• Pages: 389-397
• DOI: https://doi.org/10.1111/1471-0528.12500
• Keywords: interventions; midwifery; mental health; maternal distress; pregnancy; public health
• Public URL: http://researchrepository.napier.ac.uk/Output/2833455