The Effects of a Mindfulness-Based Intervention on Mental Health Outcomes in Pregnant Woman: A Systematic Review and Meta-Analysis.
Yanti Puspita Sari, Yu-yun Hsu, Tram Thi Bich Nguyen
The journal of nursing research : JNR December 1, 2023 DOI: 10.1097/jnr.0000000000000586
Summary
Mindfulness-based interventions (MBIs) demonstrate a small yet significant positive impact on mental health for pregnant women. An analysis of 13 studies, including 10 randomized controlled trials, revealed MBIs led to moderate reductions in stress (standardized mean difference of -0.59) and anxiety (-0.55), while showing no significant effect on depression (-0.33). The review highlighted considerable variability among studies, suggesting that future investigations should involve larger sample sizes and explore trimester-specific effects to better understand MBI efficacy during pregnancy.
Abstract
Pregnancy stress, anxiety, and depression increase the risk of short-term and long-term health problems for the mother and fetus. Mindfulness-based intervention (MBI) is one of the most popular, nonpharmacological interventions used to treat mental health problems. The results of prior research indicate MBI has a less consistent effect on mental health problems in pregnant women. The purpose of this systematic review and meta-analysis was to clarify and determine the effect of MBI on mental health outcomes in pregnant women. Six databases, including Embase, Ovid MEDLINE, CINAHL, EBSCOhost, Cochrane Library, and ScienceDirect, were searched from their dates of inception to November 2021. Google Scholar was also used for the literature inquiry. The inclusion criteria followed the PICO (Patient/Problem, Intervention, Comparison, and Outcome) model in terms of only including studies that used mindfulness therapy, reported mental health outcomes, and applied randomized controlled trial and quasi-experimental approaches. The Cochrane risk of bias tool was applied to evaluate the quality of the studies. Review Manager 5 software with random effect with a standardized mean difference (SMD) was used to analyze level of effect. Thirteen studies (10 randomized controlled trials and three quasi-experimental studies) were included. MBI was found to have a small effect on mental health outcomes in pregnant women (p < .0001, SMDs = -0.48, 95% CI [-0.74, -0.22], I2 = 87%). Specifically, MBI had moderate effects on stress and anxiety (SMDs = -0.59, 95% CI [-1.09, -0.09], and SMDs = -0.55, 95% CI [-1.00, -0.10], respectively) and no significant effect on depression (SMDs = -0.33, 95% CI [-0.74, 0.08]). MBIs have a small but notable effect on mental health in pregnant women. The high heterogeneity found in this review may reflect the different types and durations of interventions used. Notably, none of the studies in the review examined intervention effects by trimester. Future research should use larger sample sizes and assess the effects of therapy for each trimester of pregnancy.