Background
Methods
Search strategy, search terms, and database
Selection: inclusion and exclusion criteria
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▪ Papers reporting original research.
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▪ Papers focusing on the Internet use by pregnant women.
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▪ Papers were included when: (1) their participants were pregnant women; (2) their participants searched the Internet for health information or pregnancy related information.;
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▪ Papers presented their results in quantitative results, such as proportions, percentages or frequencies; and
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▪ Papers were reported in English.
Selection of studies
Quality appraisal/risk of bias
Data extraction and analysis
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Title, author, date of study;
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Details of the study including aim, design, participant recruitment/inclusion, research ethics, use of appropriate statistical methods;
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Assessment of study quality;
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Category of Internet health seeker, location, setting;
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Results of study.
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Limitations of study.
Authors and title | Ami(s) | Method | Participant | Main results or findings | Kmet et al. (2004) [26] score and quality issues |
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Bakhireva LN, et al. (2011) [22] | To examine information sources about the safety of medications during pregnancy among pregnant women. | • Tool: Questionnaires • Location: University of New Mexico clinics • Recruitment: via a bilingual interviewer. | 404 Latina pregnant women. | Internet, books and brochures were the most frequent self-identified sources of information. Women with higher education were three times more likely to seek advice than women with less than a high school education. Married and nulliparous women were more likely to seek advice than single and multiparous women, respectively. | Score = 15/20 = 75 % Study design, method and results are not sufficiently detail. No Estimating of variance reported for the main result. |
Bert, F. et al. (2013) [23] | To estimate the prevalence of pregnancy e-health seekers in a large Italian sample. | • Tool: Questionnaires • Location: Multicentre (7 Italian cities: Cassino, Chieti, Palermo, Roma, Siena, Torino and Udine). • Recruitment: via medical doctors at outpatient waiting rooms from 2011–2012. | 1347 pregnant women, aged 18–44 years. | The majority of women (95 %) were pregnancy e-health seekers. Most women search for information on the Internet once a month or more, most often during early stages of pregnancy. Main reason for searching the web was the need of further knowledge on pregnancy-related topic. | Score = 20/20 = 100 % |
Gao, L.L. et al. (2013) [5] | To investigate whether and how Chinese pregnant women used the Internet to retrieve pregnancy-related information. | • Tool: Questionnaires • Location: Antenatal clinic at Guangzhou hospital, China. • Recruitment: via a waiting-room at the antenatal clinic from September to October in 2011. | 335 Chinese pregnant women at least 32 weeks. | The majority of the women (91.9 %) had access to the Internet. Most women (88.7 %) had used the Internet on one or more occasions to access information on pregnancy, childbirth or the expected baby. The frequency of Internet searches varied from once a month to 30 times a month. | Score = 17/20 = 85 % Method not appropriate. |
Huberty J., et al. (2013) [25] | To determine how pregnant women use the Internet for health information during pregnancy including information related to physical activity and nutrition. | • Tool: Online survey and paper questionnaires were used. • Location: 1). Web study based in USA, 2). Women Infant and Children clinics, family physicians, hospital prenatal courses. • Recruitment: via handouts provided in person, and via local websites from March and December 2011. | 293 women, who were currently pregnant or up to 1 year postpartum. | Almost all women (94 %) reported using the Internet for pregnancy related information. Women reported using the Internet six to ten times for general health information about their pregnancy. Half of the women used the Internet for information related to physical activity during their pregnancy and some increased their physical activity as a result. | Score = 18/20 = 90 % Study design and method partially appropriate. |
Kavlak O, et al. (2012) [24] | To determine the extent to which pregnant women obtain information from the Internet concerning their pregnancy. | • Tool: Questionnaire • Location: Two hospitals in Izmir, Turkey (Gynaecology and Maternity Hospital and Ege University Faculty of Medicine Hospital). • Recruitment: via outpatient antenatal clinic between August and October 2009. | 185 Pregnant women in at least the 28th week of pregnancy. | 44.1 % of pregnant women had used the Internet to obtain information during their pregnancy from one to two times a week. The stages of birth (92.8 %), fetal development (81 %) and nutrition in pregnancy (58.3 %) were the most researched topics. There is a significant difference between the age group, educational level, work status and number of pregnancies and the usage of Internet among pregnant women (p ≤ 0.05). | Score = 14/20 = 70 % Question, study design, sample and estimate of variance are not adequate. |
Larsson, M. (2009) [11] | To investigate whether pregnant women used the Internet to retrieve pregnancy-related information, how they perceived the reliability of the information, and whether they discussed this information with their health providers. | • Tool: Questionnaire • Location: 11 antenatal clinics in a county in mid-Sweden. • Recruitment: via waiting-room from 11 antenatal clinics in a county in mid-Sweden during two weeks in 2004. | 182 Swedish pregnant women (mean age = 31 years), who were at least 32 weeks pregnant. | 91 % of the women had access to the Internet and, 84 % used it to retrieve information, most often in the early stages of their pregnancy. The frequency of Internet searches varied from once a month to 62 times a month. Fetal development and stages of childbirth were the two most often searched topics. Most participants considered the information to be reliable. | Score = 14/20 = 70 % Study design and subjects is limited. |
Lagan, B. M. et al. (2010) [1] | To ascertain why and how pregnant women use the Internet as a health information source, and the overall effect it had on their decision making. | • Tool: Online survey • Location: Web study based in UK. The questionnaire was uploaded onto the University of Ulster server, and 23 website moderators agreed for the study to be promoted on their specific site. • Recruitment: via Internet advertisements between July and September 2006. | 613 women who were pregnant or had a baby in the last year. Women were from 24 countries. | Most women (97 %) used search engines such as Google to identify online web pages to access a large variety of pregnancy-related information. All women (97 %) reported going online at least once to search for information on pregnancy products and two-thirds (67.4 %) to seek a second opinion. The majority of women (83 %) used Internet to influence their pregnancy decision-making. Statistically, women’s confidence levels significantly increased with respect to making decisions about their pregnancy after Internet usage (p < 0.05). | Score = 14/20 = 70 % Question, study design, method of subject and subject are not sufficiently described and appropriate. |
Results
Study selection outcome
Study characteristics
Study | Reason for exclusion |
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Hämeen-Anttila et al. (2013) [27] | The study presented a wide variety of information sources that pregnant women used during their pregnancies and Internet searching was not presented as one category. |
Laz & Berenson (2013) [28] | The study recruited all women (pregnant/non-pregnant) who searched the Internet for a variety of health problems, including menstruation, contraception, pregnancy, sexually transmitted infections. Data in relation to pregnancy information were not considered separately. |
Rodger et al. (2013) [29] | The study reported on a wide variety of social media and information and communications technologies, including: email, texting, Internet, websites, YouTube, and smartphone applications that women used during pregnancy. Internet searching was not presented as one category. |
Shieh, Mays, McDaniel, & Yu (2009) [30] | The study focused on health literacy and its association with the use of information sources including the Internet. Barriers to information seeking were also discussed. Data collection was not focussed on internet use in pregnancy. |
Song et al. (2012) [9] | Qualitative study. This article explored the way in which women used the Internet to manage their pregnancies and mediated their doctor–patient relationships. A particular emphasis was on the role of social class and personal health history in shaping Internet use. |
Weston & Anderson, 2014 [31] | Qualitative study. This study recruited three distinct groups of women: midwives, pregnant women and postnatal women. The study did not only focus on pregnancy women. |