Abstract
BackgroundMaternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.MethodsSeven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ 2 behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped-wedge RCTs and non-randomised control trials will be eligible. Studies that include a no-intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.DiscussionThe review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care and will help researchers, policy-makers and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short- and long-term health outcomes for women and their children.Systematic review registrationPROSPERO CRD42018095315
Highlights
A woman’s health behaviours during pregnancy have important implications for pregnancy and birth, as well as health outcomes for herself and her child both in the short term and across their life courses [1,2,3,4,5,6]
The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care and will help researchers, policy-makers and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short- and long-term health outcomes for women and their children
Poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors, are common maternal health behaviours associated with adverse health outcomes [7]
Summary
A woman’s health behaviours during pregnancy have important implications for pregnancy and birth, as well as health outcomes for herself and her child both in the short term and across their life courses [1,2,3,4,5,6]. Women with SNAP health behaviours in pregnancy are more likely to continue to engage in these behaviours after pregnancy [10,11,12,13], increasing their risk of obesity [14] and chronic diseases including cardiovascular disease, type II diabetes, hypertension, dyslipidaemia, stroke and some cancers [15] To address these risks, international [16, 17] and national guidelines [18, 19] recommend that pregnant women quit tobacco smoking, consume a diet that is adherent to food group recommendations, abstain from consuming alcohol and engage in 150 min of moderate physical activity each week. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women
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