Korean J Women Health Nurs.  2021 Sep;27(3):180-195. 10.4069/kjwhn.2021.09.17.

Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis

• Yoo H
• Ahn S

• KMID: 2521514
• DOI: http://doi.org/10.4069/kjwhn.2021.09.17

Abstract

Purpose
This study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor.
Methods
The following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality.
Results
Twenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges’ g=–0.67; 95% confidence interval [CI], –0.91 to –0.44), gestational diabetes (Hedges’ g=–0.38; 95% CI, –0.54 to –0.12), and preterm labor (Hedges’ g=–0.73; 95% CI, –1.00 to –0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias.
Conclusion
Nonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.

Keyword

Anxiety; Gestational diabetes; High-risk pregnancy; Mental health; Premature obstetric labor

Figure

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  Figure 1. PRISMA 9Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 flow chart for the literature review.

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  Figure 2. Risk of bias graphs for 17 randomized controlled trials (RCTs) (A, B) and 12 non-RCT studies (C, D). (A, C) Risk of bias summary. (B, D) Risk of bias for selected studies.

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  Figure 3. Effects of nonpharmacological interventions on pregnant women with preeclampsia.

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  Figure 4. Effects of nonpharmacological interventions on pregnant women with gestational diabetes mellitus.

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  Figure 5. Effects of nonpharmacological interventions on pregnant women with preterm labor.

Reference

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