Psychological Interventions for Prenatal Anxiety in Latinas and Black Women: A Scoping Review and Recommendations.

Carolyn Ponting,Guido G. Urizar,Christine Dunkel Schetter

doi:10.3389/fpsyt.2022.820343

Abstract

Anxiety symptoms are common among pregnant women worldwide. In the United States, prenatal anxiety symptoms tend to be elevated among Black and Latin American women as compared to non-Latina White women. Despite the high prevalence of anxiety and associations with adverse maternal and offspring outcomes, interventions have not been developed or tailored sufficiently to Black women or Latinas who need efficacious treatment. This article provides a scoping review of articles published since 2017 that test the effects of randomized and non-randomized psychological interventions designed to reduce prenatal anxiety in samples comprised primarily of ethnic/racial minority women. We also review published protocols of planned psychological interventions to reduce prenatal anxiety in order to highlight novel approaches. In addition to summarizing intervention efficacy and participant acceptability, we highlight gaps in the literature which, if addressed, could improve perinatal mental health equity. Finally, we discuss future directions in prenatal anxiety intervention science beginning preconception including intervention design and prevention models.

Highlights

Specialty section: This article was submitted to Anxiety and Stress Disorders, a section of the journal Frontiers in Psychiatry
We provide an update to the Ponting et al [31] review by searching for psychological interventions reporting on prenatal anxiety efficacy in studies enrolling at least 50% Black women and Latinas from 2017 through 2021
The authors reported that women randomized to nine sessions of individual interpersonal psychotherapy for depression delivered by mental health professionals, did not show significant reductions in anxiety symptoms

Summary

Introduction

Specialty section: This article was submitted to Anxiety and Stress Disorders, a section of the journal Frontiers in Psychiatry. Despite the high prevalence of anxiety and associations with adverse maternal and offspring outcomes, interventions have not been developed or tailored sufficiently to Black women or Latinas who need efficacious treatment. Pregnant women with anxiety are less likely to adhere to prenatal care recommendations such as abstaining from substance use or engaging in positive health behaviors [6, 7]. They may avoid prenatal healthcare because it can trigger health-related worries [8]. Given its high prevalence and associated longterm health risks for mothers and their children, prenatal anxiety screening and interventions are urgently needed. While the American College of Obstetricians and Gynecologists [15] maintains that the cost-benefit analysis for medication ought to be made on a case-by-case basis, psychotherapy is widely considered as a first line intervention to reduce prenatal anxiety

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