Literature DB >> 24397691

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

Y J Fontein-Kuipers1, M J Nieuwenhuijze, M Ausems, L Budé, R de Vries.   

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.
© 2014 Royal College of Obstetricians and Gynaecologists.

Entities:  

Keywords:  Interventions; maternal distress; mental health; midwifery; pregnancy; public health

Mesh:

Year:  2014        PMID: 24397691     DOI: 10.1111/1471-0528.12500

Source DB:  PubMed          Journal:  BJOG        ISSN: 1470-0328            Impact factor:   6.531


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