Effects of interventions for women and their partners to reduce or prevent stress and anxiety: A systematic review

Abstract

Background: The period from conception to two years postpartum (the first 1000 days) represents a normative transitional period, which can be potentially stressful for some parents. Parental stress and anxiety adversely impacts psychological and physical health for parents and children. Aim: The aim of this review is to systematically examine effects of interventions for women and their partners to reduce or prevent stress and/or anxiety during the first 1000 days. Methods: MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Randomised controlled trials examining intervention effects on parental stress and/or anxiety during first 1000 days were eligible for inclusion. Data were independently extracted by two reviewers and narratively synthesised. Findings: Fifteen interventions, reported in 16 studies, met inclusion criteria (n = 1911 participants). Overall, findings were inconsistent and the majority of trials demonstrated high risk of bias. Interventions were predominantly delivered to women during pregnancy and only two studies included fathers. There was some evidence that adapting interventions to the pre and postnatal periods provided benefits for stress and anxiety reduction, however there was limited evidence for individual intervention types or approaches. Conclusions: There is currently inconsistent evidence of what interventions are most effective for women during the first 1000 days and there is insufficient evidence for any interventions for male partners during this period. There is a clear need for rigorous development and examination of interventions developed specifically to reduce or prevent stress and/or anxiety across the first 1000 days.

Maternal Stressors and Coping Strategies During the Extended Postpartum Period: A Retrospective Analysis with Contemporary Implications

“…Fortunately, intervention models for women experiencing postpartum stress have been tested, although all are not successful in achieving stress reduction. 70 , 71 Programs classified by Song et al as supportive stress management were found to be especially effective. 70 For example, a support group intervention focused on maternal transition, stress management, communication, and life planning reduced stress for distressed mothers.…”

“Crippling and unfamiliar”: Analysing the concept of perinatal anxiety; definition, recognition and implications for psychological care provision for women during pregnancy and early motherhood

“…Even if support can be accessed, there is little substantial evidence to suggest the most effective approach to reducing perinatal anxiety (Matvienko‐Sikar et al., 2020), adding another layer of complexity regarding not just diagnosis but appropriate management, including which services are best placed to deliver psychological care. Health professionals and service users in the UK find that mental healthcare systems are not well integrated and are hard to navigate (NHS‐E/I, 2019): this raises questions about the role of midwives, as the primary healthcare professionals during the perinatal period, in supporting integrated mental health care and/or delivering psychological therapy.…”

“…Even if support can be accessed, there is little substantial evidence to suggest the most effective approach to reducing perinatal anxiety (Matvienko-Sikar et al, 2020)…”

A Review of the Involvement of Partners and Family Members in Psychosocial Interventions for Supporting Women at Risk of or Experiencing Perinatal Depression and Anxiety

“…The prevalence of depression and anxiety varies across the perinatal period and is dependent on differences within populations, timing of assessments, type of screening instruments, and assessment criteria [ 4 , 6 ]. A meta-analysis reported that perinatal depression affects 12.9% of mothers [ 7 ] and estimates ranging from 2.6 to 39% have been reported for perinatal anxiety [ 8 ].…”