EFFECTIVENESS OF PERINATAL MINDFULNESS-BASED INTERVENTIONS ON MENTAL HEALTH OUTCOMES OF PSYCHOLOGICALLY VULNERABLE MOTHERS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: Poor perinatal mental health is adversely associated with maternal and infants outcomes. While pharmacological intervention is the most routinely prescribed treatment for mental health difficulties, Mindfulness-based interventions (MBIs) has been contended to offer a novel non-pharmacological approach to treating perinatal mental health difficulties due to the potential risks for both pregnant and breastfeeding women tied together with concerns about teratogenicity. Objectives: This review aims to synthesize the best available evidence to assess the effectiveness of mindfulness-based interventions (MBIs) on mental health outcomes of psychologically vulnerable mothers during the perinatal period. Methods: Studies in English-language were identified through systematic searches of the eight databases from their inception until 22 January 2021 using the search concepts “mindfulness”, “perinatal” and “mental health”: PubMed, EMBASE, CINAHL, Cochrane, PsycINFO and Scopus. Meta-analysis was performed by pooling the data from randomised control trials (RCTs) using the RevMan V.5.4 software. Heterogeneity was assessed using the I2 and X2 values while the overall effect was evaluated using effect size and the Z-statistics. Results: 10 studies comprising 864 participants across five countries were included. Metaanalysis of stress and mindfulness revealed small effect sizes favouring MBIs in comparison to control groups. Due to the moderate heterogeneity mindfulness, sensitivity and subgroup analyses were conducted. Data on anxiety and depression were narratively synthesised in view of high heterogeneity hence reporting the findings intelligibly. Conclusion and implications MBIs have proven to effectively reduce stress, anxiety, depression and improve mindfulness among the psychologically vulnerable perinatal population and therefore this review serves to inform clinical practice in the efforts to encourage the application of a scientific MBI regimen perhaps as an adjunctive therapy to standard care. Inclusion of studies with high methodological quality and larger sample sizes in future research would further support the effectiveness of MBIs.