EFFECTIVENESS OF DIGITAL PSYCHOLOGICAL INTERVENTIONS IN IMPROVING MENTAL HEALTH OUTCOMES AMONG PREGNANT WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Aims: To investigate the effectiveness of digital psychological interventions on mental health outcomes of pregnant women. Background: Declining mental health is common during pregnancy and can lead to negative maternal and infant outcomes. Digital interventions are increasingly more relevant and accessible for timely treatment. Data Sources: Literature search of seven databases was carried out to identify published and unpublished randomised controlled trials in English without any time limitation up to February 2021. Eligibility criteria: The population included pregnant women. The interventions included digital psychological interventions. The comparators were treatment as usual or waitlist control. The outcomes were depressive, anxiety, stress, and fear symptoms. Study Appraisal: Cochrane Risk of Bias (ROB) tool and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool were used to evaluate individual and overall quality of evidence. Synthesis Methods: Using RevMan 5.4., meta-analysis was conducted. Overall intervention effects were tested using Z-statistic at p<0.05, while Cochran’s Q test and I2 statistics were used for measuring heterogeneity. Sensitivity analyses and subgroup analyses were conducted. Results: Based on 11 included trials involving 2,855 pregnant women in 10 countries, digital psychological interventions can significantly improve depressive and anxiety symptoms of the intervention group compared to the comparator group. However, no significant benefits were concluded for stress and fear of childbirth. There was substantial heterogeneity in the included studies. Implications: Future practice can include professional-supported digital psychological interventions lasting at least eight weeks, targeting pregnant women with mental disorder symptoms, in East Asia and the Pacific. Future studies: Based on mixed individual ROB and low overall GRADE ratings, future research is needed to improve the quality of evidence. Characteristics that optimise the digital psychological interventions, adherence and acceptability of interventions can be investigated. Conclusion: Digital psychological interventions were found to be effective in reducing antenatal depressive and anxiety symptoms.