eHealth interventions for treatment and prevention of depression, anxiety, and insomnia during pregnancy: systematic review and Meta-analysis
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Abstract
BACKGROUND: Pregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. OBJECTIVE: The objective of this systematic review and meta-analysis is to determine the effectiveness of eHealth interventions in preventing and treating depression, anxiety, and insomnia during pregnancy. Secondary aims are to identify demographic and intervention moderators of effectiveness. METHODS: A total of 5 databases (PsycINFO, Medline, CINAHL, Embase, and Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials (RCTs), depression, anxiety, and insomnia were included. RCTs and pilot RCTs were included if they reported an eHealth intervention for the prevention or treatment of depression, anxiety, or insomnia in pregnant women. Study screening, data extractions, and quality assessment were conducted independently by 2 reviewers from an 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, and Beatrice Valmana). Random-effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. RESULTS: In total, 17 studies were included in this review that assessed changes in depression (11/17, 65%), anxiety (10/17, 59%), and insomnia (3/17, 18%). Several studies included both depression and anxiety symptoms as outcomes (7/17, 41%). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where mindfulness interventions outperformed other intervention types, no significant moderators were detected. CONCLUSIONS: eHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression, and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. TRIAL REGISTRATION: PROSPERO (International Prospective Register of Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954.
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In PPD prevention, small effect sizes were found in studies conducted during pregnancy.
“In terms of PPD prevention, small effect sizes were found in studies conducted during pregnancy (Silang et al., 2022)”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Silang et al., 2022
The Results (Effectiveness of eHealth Interventions for Treatment of Depressive Symptoms During Pregnancy; page unavailable) report a small pooled effect on depressive symptoms, and the Abstract Results describe small effects for preventing and treating depression during pregnancy. The paper does not report a separate effect size for preventing postpartum depression (PPD), so the PPD-specific part of the claim is not established. (LLM, conf=0.84)
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- Authors
- Silang, K. A., Sohal, P. R., Bright, K. S., Leason, J., Roos, L., Lebel, C., Giesbrecht, G. F., & Tomfohr-Madsen, L. M.
- Affiliations
- University of Calgary (CA)
- Alberta Health Services (CA)
- Children's Hospital Research Institute of Manitoba (CA)
- Alberta Children's Hospital Research Institute (CA)
- ORCID
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2022-02-21
- Volume
- 9
- Issue
- 2
- Pages
- e31116
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC8902665
- OpenAlex
- W3214102909
- Cited by
- 50
- References
- 95
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 14 · 2023: 15 · 2022: 2 · 2021: 1
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Children's Hospital Foundation
- Canadian Child Health Clinician Scientist Program
- Alberta Children's Hospital Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- digital health interventions, pregnancy, antenatal depression, prenatal anxiety, prenatal mental health, mindfulness-based interventions, moderators of intervention effectiveness, intervention types, depressive symptoms, anxiety symptoms
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