Abstract
PurposeThis study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor.MethodsThe following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality.ResultsTwenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges’ g=–0.67; 95% confidence interval [CI], –0.91 to –0.44), gestational diabetes (Hedges’ g=–0.38; 95% CI, –0.54 to –0.12), and preterm labor (Hedges’ g=–0.73; 95% CI, –1.00 to –0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias.ConclusionNonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.
Highlights
High-risk pregnancy refers to a pregnancy that can threaten the health and life of the pregnant woman, fetus, or newborn [1]
What this paper adds This systematic review and meta-analysis found that nonpharmacological interventions exerted positive effects on anxiety, depression, and stress among high-risk pregnant women with preeclampsia, gestational diabetes, or preterm labor
Quality evaluation of selected studies Quality evaluation using RoB 2 was performed for the 17 randomized controlled trials (RCTs) [26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42]
Summary
High-risk pregnancy refers to a pregnancy that can threaten the health and life of the pregnant woman, fetus, or newborn [1]. The proportion of premature births alone increased from 4.9% in 2006 to 7.7% in 2018 in Korea [1]. These findings indicate that high-risk pregnancies are continuing to become more common. Among the conditions that cause high-risk pregnancies, preeclampsia, gestational diabetes mellitus (GDM), and preterm labor (PTL) before 34 weeks of pregnancy are the most common [2]. The Korean Society of Obstetrics and Gynecology classifies these three as factors that cause a moderate- or higher-risk pregnancy and notes that intensive observation and Korean J Women Health Nurs 2021;27(3):180195
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