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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.


M.J. Nieuwenhuijze

M. Ausems

L. Bud�

R. de Vries


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.

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
Keywords interventions; midwifery; mental health; maternal distress; pregnancy; public health
Public URL