eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis

BackgroundPregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. ObjectiveThe objective of this systematic review and meta-...

Full description

Bibliographic Details
Main Authors: Katherine A Silang, Pooja R Sohal, Katherine S Bright, Jennifer Leason, Leslie Roos, Catherine Lebel, Gerald F Giesbrecht, Lianne M Tomfohr-Madsen
Format: Article
Language:English
Published: JMIR Publications 2022-02-01
Series:JMIR Mental Health
Online Access:https://mental.jmir.org/2022/2/e31116
_version_ 1797735318808428544
author Katherine A Silang
Pooja R Sohal
Katherine S Bright
Jennifer Leason
Leslie Roos
Catherine Lebel
Gerald F Giesbrecht
Lianne M Tomfohr-Madsen
author_facet Katherine A Silang
Pooja R Sohal
Katherine S Bright
Jennifer Leason
Leslie Roos
Catherine Lebel
Gerald F Giesbrecht
Lianne M Tomfohr-Madsen
author_sort Katherine A Silang
collection DOAJ
description BackgroundPregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. ObjectiveThe objective of this systematic review and meta-analysis is to determine the effectiveness of eHealth interventions in preventing and treating depression, anxiety, and insomnia during pregnancy. Secondary aims are to identify demographic and intervention moderators of effectiveness. MethodsA total of 5 databases (PsycINFO, Medline, CINAHL, Embase, and Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials (RCTs), depression, anxiety, and insomnia were included. RCTs and pilot RCTs were included if they reported an eHealth intervention for the prevention or treatment of depression, anxiety, or insomnia in pregnant women. Study screening, data extractions, and quality assessment were conducted independently by 2 reviewers from an 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, and Beatrice Valmana). Random-effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. ResultsIn total, 17 studies were included in this review that assessed changes in depression (11/17, 65%), anxiety (10/17, 59%), and insomnia (3/17, 18%). Several studies included both depression and anxiety symptoms as outcomes (7/17, 41%). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where mindfulness interventions outperformed other intervention types, no significant moderators were detected. ConclusionseHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression, and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. Trial RegistrationPROSPERO (International Prospective Register of Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954
first_indexed 2024-03-12T12:56:16Z
format Article
id doaj.art-3001e638f9204c1a8f0766d108e722f7
institution Directory Open Access Journal
issn 2368-7959
language English
last_indexed 2024-03-12T12:56:16Z
publishDate 2022-02-01
publisher JMIR Publications
record_format Article
series JMIR Mental Health
spelling doaj.art-3001e638f9204c1a8f0766d108e722f72023-08-28T20:50:59ZengJMIR PublicationsJMIR Mental Health2368-79592022-02-0192e3111610.2196/31116eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysisKatherine A Silanghttps://orcid.org/0000-0002-4660-7583Pooja R Sohalhttps://orcid.org/0000-0003-1506-3349Katherine S Brighthttps://orcid.org/0000-0002-6607-7655Jennifer Leasonhttps://orcid.org/0000-0002-3903-7279Leslie Rooshttps://orcid.org/0000-0001-7083-4017Catherine Lebelhttps://orcid.org/0000-0002-0344-4032Gerald F Giesbrechthttps://orcid.org/0000-0001-7259-0685Lianne M Tomfohr-Madsenhttps://orcid.org/0000-0002-0860-5392 BackgroundPregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. ObjectiveThe objective of this systematic review and meta-analysis is to determine the effectiveness of eHealth interventions in preventing and treating depression, anxiety, and insomnia during pregnancy. Secondary aims are to identify demographic and intervention moderators of effectiveness. MethodsA total of 5 databases (PsycINFO, Medline, CINAHL, Embase, and Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials (RCTs), depression, anxiety, and insomnia were included. RCTs and pilot RCTs were included if they reported an eHealth intervention for the prevention or treatment of depression, anxiety, or insomnia in pregnant women. Study screening, data extractions, and quality assessment were conducted independently by 2 reviewers from an 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, and Beatrice Valmana). Random-effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. ResultsIn total, 17 studies were included in this review that assessed changes in depression (11/17, 65%), anxiety (10/17, 59%), and insomnia (3/17, 18%). Several studies included both depression and anxiety symptoms as outcomes (7/17, 41%). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where mindfulness interventions outperformed other intervention types, no significant moderators were detected. ConclusionseHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression, and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. Trial RegistrationPROSPERO (International Prospective Register of Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954https://mental.jmir.org/2022/2/e31116
spellingShingle Katherine A Silang
Pooja R Sohal
Katherine S Bright
Jennifer Leason
Leslie Roos
Catherine Lebel
Gerald F Giesbrecht
Lianne M Tomfohr-Madsen
eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis
JMIR Mental Health
title eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis
title_full eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis
title_fullStr eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis
title_full_unstemmed eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis
title_short eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis
title_sort ehealth interventions for treatment and prevention of depression anxiety and insomnia during pregnancy systematic review and meta analysis
url https://mental.jmir.org/2022/2/e31116
work_keys_str_mv AT katherineasilang ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT poojarsohal ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT katherinesbright ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT jenniferleason ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT leslieroos ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT catherinelebel ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT geraldfgiesbrecht ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis
AT liannemtomfohrmadsen ehealthinterventionsfortreatmentandpreventionofdepressionanxietyandinsomniaduringpregnancysystematicreviewandmetaanalysis