Systematic review and meta-analysis of non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women

Evans, Kerry; Morrell, C. Jane; Spiby, Helen

Abstract

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; PsycINFO; 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.

Citation

Evans, K., Morrell, C. J., & Spiby, H. (2018). Systematic review and meta-analysis of non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. Journal of Advanced Nursing, 74(2), 289-309. https://doi.org/10.1111/jan.13456

• Journal Article Type: Article
• Acceptance Date: Aug 9, 2017
• Online Publication Date: Oct 16, 2017
• Publication Date: Feb 1, 2018
• Deposit Date: Nov 1, 2017
• Publicly Available Date: Oct 17, 2018
• Journal: Journal of Advanced Nursing
• Print ISSN: 0309-2402
• Electronic ISSN: 1365-2648
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 74
• Issue: 2
• Pages: 289-309
• DOI: https://doi.org/10.1111/jan.13456
• Keywords: antepartum; anxiety; midwifery; nurses; nursing; pregnancy; systematic reviews and meta-analyses
• Public URL: https://nottingham-repository.worktribe.com/output/962695
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/jan.13456/full
• Additional Information: This is the peer reviewed version of the following article: Evans K, Morrell CJ, Spiby H. Systematic review and meta-analysis of non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. J Adv Nurs. 2017;00:1–21, which has been published in final form at http://dx.doi.org/10.1111/jan.13456. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.