Systematic review and meta‐analysis of non‐pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women
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Aim: To assess the effectiveness of non‐pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety. Background: Many pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non‐pharmacological interventions have been suggested for use during pregnancy. Design: A systematic review of randomized controlled trials. Data sources: Randomized controlled trials published since 1990, identified from electronic databases: Medline; CINAHL; Maternity and Infant Care; Psyc INFO; Cochrane Database of Systematic Reviews; CENTRAL; EMBASE; Centre for Reviews and Dissemination; Social Sciences Citation Index; ASSIA; HTA Library; Joanna Briggs Institute Evidence‐Based Practice database; Allied and Complementary Medicine. Review methods: Conducted according to the Centre for Reviews and Dissemination procedure. Papers were screened (N = 5,222), assessed for eligibility (N = 57) and selected for inclusion (N = 25). The Cochrane Collaboration's tool for assessing risk of bias was used. Papers were assessed for clinical and statistical heterogeneity and considered for meta‐analysis. Descriptive analysis of the data was conducted. Results: Psychological, mind‐body, educational and supportive interventions were delivered individually and to groups of pregnant women over single or multiple sessions. The State‐Trait Anxiety Inventory was the most commonly used anxiety measure. In 60% of studies there were fewer than 40 participants. Meta‐analysis of three studies indicated no observed beneficial effect in the reduction of anxiety. Conclusion: There was insufficient evidence from which to draw overall conclusions regarding the benefit of interventions. Results were predominantly based on small samples. Many papers provided an inadequate description of methods which prevented a full assessment of methodological quality.
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Much is unknown about the effectiveness of preventive interventions on other forms of distress beyond depression, such as anxiety and general stress.
“However, much is unknown about the effectiveness of preventive interventions on other forms of distress beyond depression, such as anxiety and general stress [56, 58].”
Much less is known about universally applicable interventions that target all pregnant women, without pre-existing symptomatology or risk factors.
“Furthermore, much less is known about universally applicable interventions that target all pregnant women, without pre-existing symptomatology or risk factors [56, 58].”
Much less is known about the effectiveness of universal prevention during pregnancy compared with indicated or selected prevention.
“In contrast to indicated or selected prevention, much less is known about the effectiveness of universal prevention during pregnancy [56, 58].”
The study included a variety of distress outcomes, including stress related to the parenting role and symptoms of anxiety, whereas most prevention studies focused on depression as an outcome measure.
“Third, while most prevention studies focused on depression as an outcome measure [56, 58], we included a variety of distress outcomes, including stress related to the parenting role and symptoms of anxiety.”
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- Authors
- Evans, K., Morrell, C. J., & Spiby, H.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Evans, Kerry
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2017-10-16
- Volume
- 74
- Issue
- 2
- Pages
- 289-309
- ISSN
- 0309-2402 (ISSN-L)
- 1365-2648
- OpenAlex
- W2756254589
- Cited by
- 33
- References
- 77
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 2 · 2018: 1
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Advanced Nursing (publishedVersion)
- PubMed (publishedVersion)
- Nottingham ePrints (University of Nottingham) (submittedVersion, cc-by)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Funders
- Royal College of Midwives
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- prenatal anxiety, non-pharmacological treatment, pregnant women, mind-body interventions, psychological intervention, educational intervention, support measures, anxiety reduction, State-Trait Anxiety Inventory
- MeSH terms
- Adult, Anxiety Disorders, Behavior Therapy, Female, Humans, Pregnancy, Randomized Controlled Trials as Topic, Pregnant People
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