Background
Method
Search strategy and selection criteria
Offspring outcome measures
Data analysis
Results
Author, year | Study focus | Selection criteria | Conditions and timing of intervention | No. of participants | Authors conclude sign. Effect of intervention on mother? | Offspring measures | Country | Risk of bias | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
S | C | B | A | I | R | O | T | ||||||||
Bastani, 2006 [53] | Anxiety | STAI > 30 | IG: Applied relaxation training, 7 wk. group sessions CG: TAU Prenatal | IG, 52; CG, 52; Total, 104 | Yes, on anxiety symptoms |
Medical records:
BW & GA | Iran | ? | ? | ? | ? | + | – | ? | H |
Cappon, 2015 [54] x | Anxiety | BAI ≥ 21 | IG: Listening to music, 20 to 296 times individually CG: TAU Prenatal | IG, 36; CG, 37; Total, 73 | Yes, on anxiety symptoms |
Questionnaire:
BW & GA. IBQ-r at age 2 to 3 months | USA | ? | ? | + | + | – | + | + | L |
Chambers, 2009 [55] x | Anxiety | STAI; State or trait subscale ≥ 40 | IG: 6 wk. individual relaxation training CG: List of tips for reducing stress Prenatal | IG, 10; CG, 12; Total, 22 | No | Medical records: BW & GA & Apgar scores | USA | + | ? | – | + | – | + | – | H |
Fenwick, 2015 [56] | Fear of childbirth | W-DEQ ≥ 66 | IG: Telephone psycho-education, 2 sessions CG: TAU Prenatal | IG, 91; CG, 93; Total, 184 | Yes, on flashbacks | Medical records: GA. Hospitalization up to 6 weeks | Australia | + | – | – | + | + | + | + | L |
Field, 2009 [45] | Depression | SCID diagnosis MDD | IG: Massage therapy, 12 wk. sessions CG: TAU Prenatal | IG, 88; CG, 61; Total, 149 | Yes, on depressive symptoms | Medical records: BW & GA. Saliva (cortisol) & BNBAS at age 2 days | USA | + | ? | – | + | – | – | – | H |
Karamoozian, 2015 [51] | Depression & Anxiety | EPDS > 9 & PRAQ high score | IG: 12 wk. group CBSM CG: TAU Prenatal | IG, 14; CG, 15; Total, 29 | Yes, on anxiety and depressive symptoms | Apgar scale: Apgar scores | Iran | ? | ? | ? | ? | + | + | – | H |
Madigan, 2015 [58] | PTSD in adolescents | CPTSDI PTSD diagnosis or AAI unresolved state of mind | IG: 12 wk. trauma focused CBT plus 12 sessions parenting course CG: Parenting course (TAU) Prenatal | IG, 12; CG, 14; Total, 26 | No | ASSP at age 12 months | Canada | ? | ? | ? | + | + | + | – | L |
Maselko, 2015 [46] a* | Depression | SCID diagnosis MDD | IG: Thinking healthy programme (CBT based), 7 wk. visits and 9 monthly visits CG: Enhanced routine care Prenatal and postpartum | IG, 289; CG, 295; Total, 584 | Yes, less MDD diagnoses in IG | SDQ, SCAS, weight, height, and BMI at age 7 years | Pakistan | + | + | + | + | + | – | – | L |
Milgrom, 2015 [50] | Depression | SCID diagnosis MDD and EPDS ≥ 13 | IG: Beating blues before birth (CBT based), 8 sessions CG: TAU Prenatal | IG, 16; CG, 13; Total, 29 | Yes, on depressive and anxiety symptoms | Medical records: BW & GA. IBQ-R, ASQ-3, and ASQ-SE at age 9 months | Australia | + | + | ? | + | + | – | – | M |
Netsi, 2015 [47] | Depression | CIS diagnosis MDD | IG: 12 sessions individual CBT CG: TAU Prenatal | IG, 14; CG, 11; Total, 25 | Yes, on depressive symptoms | Medical records: BW. ICQ and BISQ at age 2 months | UK | + | + | – | + | – | + | – | H |
Rahman, 2008 [44]* | Depression | SCID diagnosis MDD | IG: Thinking healthy programme (CBT based), 7 wk. visits and 9 monthly visits CG: Enhanced routine care Prenatal and postpartum | IG, 440; CG, 463; Total, 903 | Yes, on MDD diagnoses | Records: Weight, height, health at ages 6 and 12 months | Pakistan | + | + | + | + | + | + | + | L |
Rothberg, 1991 [59] | Stress | SRRS ≥ 39 | IG: Psychosocial support during each antenatal clinic visit CG: TAU Prenatal | IG, 43; CG, 43; Total, 86 | No | Medical records & Ballard score: BW & GA. Height, hospitalization at birth | South Africa | + | ? | ? | + | – | + | – | H |
Rouhe, 2013 [57] | Fear of childbirth | W-DEQ ≥ 100 | IG: 6 sessions psycho-educative group therapy CG: TAU Prenatal and postpartum | IG, 131; CG, 240; Total: 371 | Yes, on fear symptoms | Medical records: BW & GA & Apgar scores. Arterial Ph. at birth | Finland | + | + | – | – | – | + | – | H |
Urizar, 2011 [48] | Depression | CES-D ≥ 16 or past history of MDD | IG: 12 wk. group CBSM CG: TAU Prenatal | IG, 24; CG, 29; Total, 53 | No | Saliva (cortisol) at ages 6 and 18 months | USA | ? | ? | ? | ? | + | + | – | H |
Verbeek, 2016[52]x | Depression & Anxiety | EPDS ≥ 12 or STAI ≥ 42 | IG: 10 to 12 sessions individual CBT CG: TAU Prenatal and postpartum | IG, 121; CG, 120; Total, 241 | No | Medical records: BW & GA & Apgar scores | NL | + | + | – | + | + | + | + | L |
Verbeek, 2016b [52] b x | Depression & Anxiety | EPDS ≥ 12 or STAI ≥ 42 | IG: 10 to 12 sessions individual CBT CG: TAU Prenatal and postpartum | IG, 97; CG, 99; Total, 196 | No | CBCL and BSID at age 18 months | NL | + | + | – | + | + | + | + | L |
Vilhena, 2017 [60] | Common mental disorder in obese women | SRQ-20 ≥ 8 | IG: Homeopathy, 2 times a day, 4 days a week CG: Placebo Prenatal | IG, 62; CG, 72; Total, 134 | No |
Records:
GA, BW, Apgar of 10 at 5 min after birth | Brazil | + | + | + | ? | ? | + | – | L |
Zhao, 2017 [49] | Depression | EPDS ≥ 9 or PDSS ≥ 20 | IG: 6 sessions couple-separated psycho-educational program for first time parents CG: TAU Prenatal | IG, 175; CG, 174; Total, 349 | Yes, on depressive status |
Medical records:
GA, BW | China | + | ? | ? | ? | + | + | ? | L |
Author, year | Mean birth weight (Sd.) in grams | Mean Apgar score (Sd.) | Mean gestational age (Sd.) in weeks |
---|---|---|---|
Bastani, 2006 [53] | IG, 3168 (420) CG, 2883 (640) | n/a | IG, 38 (5.9) CG, 38 (4.4) |
Cappon, 2015 [54] | IG, 3366 (523) CG, 3344 (773) | n/a | n/a |
Chambers, 2009 [55] | IG, 3232 (695) CG, 3562 (529) | IG, Apgar 1 min: 7.8 (1.3) CG, Apgar 1 min: 8 (1.1) IG, Apgar 5 min: 8.5 (0.7) CG, Apgar 5 min: 9.1 (0.3) | IG, 38.4 (2.5) CG, 39.5 (1.4) |
Fenwick, 2015 [56] | n/a | n/a | IG, 39.2 (1.6) CG, 39.1 (2.0) |
Field, 2009 [45] | IG, 3318 (360) CG, 3226 (492) | n/a | IG, 39 (1.2) CG, 38.7 (1.6) |
Karamoozian, 2015 [51] | n/a | IG, Apgar 1 min: 8.9 (0.3) CG, Apgar 1 min: 8.1 (0.8) IG, Apgar 5 min: 9.7 (0.5) CG, Apgar 5 min: 9.3 (0.7) | n/a |
Milgrom, 2015 [50] | IG, 3626 (786) CG, 3575 (595) | n/a | IG, 40 (1) CG, 40 (2) |
Netsi, 2015 [47] | IG, 3423 (503) CG, 3180 (871) | n/a | n/a |
Rothberg, 1991 [59] | IG, 3214 (649) CG, 3113 (690) | n/a | IG, 38.7 (3) CG, 38.3 (2.7) |
Rouhe, 2013 [57] | IG, 3532 (550) CG, 3486 (518) | IG, Apgar 1 min: 8.7 (1.1) CG, Apgar 1 min: 8.5 (1.4) IG, Apgar 5 min: 9.3 (1.0) CG, Apgar 5 min: 9.1 (1.2) IG, Apgar 10 min: 9.7 (0.8) CG, Apgar 10 min: 9.5 (0.9) | IG, 39.7 (1.5) CG, 39.6 (1.6) |
Verbeek, 2016; Verbeek, 2016b [52] | IG, 3419 (651) CG, 3474 (561) | IG, Apgar 1 min: 8.6 (n/a) CG, Apgar 1 min: 8.6 (n/a) IG, Apgar 5 min: 9.5 (n/a) CG, Apgar 5 min: 9.5 (n/a) IG, Apgar 10 min: 9.8 (n/a) CG, Apgar 10 min: 9.8 (n/a) | IG, 38.9 (2.3) CG, 39.2 (1.8) |
Vilhena, 2017 [60] | IG, 3390 (440) CG, 3270 (560) | n/a | IG, 39.4 (1.2) CG, 38.9 (1.9) |
Zhao, 2017 [49] | IG, 3256 (522) CG, 3349 (529) | n/a | n/a |
Combined range per offspring outcome | Lowest value, 2883 Highest value, 3626 | Lowest value, 7.8 Highest value, 9.8 | Lowest value, 38 Highest value, 40 |
N
| No. of participants |
g
| 95% CI |
p
|
I
2
| 95% CI |
p
a
| ||
---|---|---|---|---|---|---|---|---|---|
Effect of prenatal interventions on offspring outcomes (BW, GA, Apgar) | 13 | 1796 | 0.09 | − 0.03 to 0.21 | 0.14 | 23 | 0–60 | ||
Effect of prenatal interventions for each offspring outcome | 11 | 1583 | 0.08 | − 0.06 to 0.22 | 0.27 | 39 | 0–70 | ||
10 | 1669 | 0.03 | − 0.06 to 0.13 | 0.49 | 0 | 0–53 | |||
4 | 663 | 0.13 | − 0.28 to 0.54 | 0.53 | 68 | 0–87 | |||
Subgroup analyses | |||||||||
Type of diagnosis* | 6 | 852 | − 0.01 | − 0.22 to 0.20 | 0.89 | 40 | 0–75 | 0.41 | |
5 | 668 | 0 | − 0.33 to 0.32 | 1 | 70 | 22–88 | |||
5 | 779 | − 0.06 | − 0.24 to 0.12 | 0.54 | 27 | 0–71 | |||
5 | 575 | 0.02 | − 0.15 to 0.18 | 0.86 | 0 | 0–79 | |||
5 | 575 | 0.01 | − 0.20 to 0.23 | 0.90 | 22 | 0–68 | |||
4 | 550 | 0.05 | − 0.12 to 0.21 | 0.58 | 0 | 0–85 | |||
4 | 283 | 0.22 | − 0.90 to 0.54 | 0.17 | 62 | 0–85 | |||
3 | 254 | 0.06 | − 0.15 to 0.27 | 0.57 | 22 | 0–97 | |||
3 | 254 | 0.07 | − 0.19 to 0.33 | 0.60 | 45 | 0–84 | |||
Risk of bias | 7 | 786 | 0.21 | − 0.00 to 0.42 |
0.05
| 31 | 0–70 | 0.09 | |
6 | 1010 | − 0.00 | − 0.13 to 0.12 | 0.97 | 0 | 0–61 | |||
Diagnosis through clinical interview or self-report | 3 | 203 | 0.20 | − 0.07 to 0.47 | 0.15 | 0 | 0–90 | 0.43 | |
10 | 1593 | 0.08 | − 0.06 to 0.22 | 0.28 | 36 | 0–70 | |||
Type of intervention | 7 | 1130 | 0.08 | − 0.10 to 0.27 | 0.40 | 39 | 0–75 | 0.67 | |
6 | 666 | 0.13 | − 0.02 to 0.28 | 0.09 | 0 | 0–74 | |||
Report of sign. Effect of intervention on mother? | 4 | 483 | 0.05 | − 0.18 to 0.28 | 0.68 | 31 | 0–75 | 0.64 | |
9 | 1313 | 0.11 | − 0.04 to 0.26 | 0.14 | 29 | 0–67 |