Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review

Abstract

Background Pregnancy and the postpartum period are times when women are at increased risk for depression and mental problems. This may also negatively affect the foetus. Thus, there is a need for interventions with low-threshold access and care. Telemedicine interventions are a promising approach to address these issues. This systematic literature review examined the efficacy of telemedicine interventions for pregnant women and/or new mothers to address mental health-related outcomes. The primary objective was to analyse whether telemedicine interventions can reduce mental health problems in pregnant women and new mothers. The secondary aim was to clarify the impact of type of interventions, their frequency and their targets. Methods Inclusion criteria: randomized controlled trials, with participants being pregnant women and/or new mothers (with infants up to twelve months), involving telemedicine interventions of any kind (e.g. websites, apps, chats, telephone), and addressing any mental health-related outcomes like depression, postnatal depression, anxiety, stress and others. Search terms were pregnant women, new mothers, telemedicine, RCT (randomised controlled trials), mental stress as well as numerous synonyms including medical subject headings. The literature search was conducted within the databases PubMed, Cochrane Library, Web of Science and PsycINFO. Screening, inclusion of records and data extraction were performed by two researchers according to the PRISMA guidelines, using the online tool CADIMA. Results Forty four articles were included. A majority (62%) reported significantly improved mental health-related outcomes for participants receiving telemedicine interventions compared to control. In particular (internet-delivered) Cognitive Behavioural Therapy was successful for depression and stress, and peer support improved outcomes for postnatal depression and anxiety. Interventions with preventive approaches and interventions aimed at symptom reduction were largely successful. For the most part there was no significant improvement in the symptoms of anxiety. Conclusion Telemedicine interventions evaluated within RCTs were mostly successful. However, they need to be designed to specifically target a certain mental health issue because there is no one-size-fits-all approach. Further research should focus on which specific interventions are appropriate for which mental health outcomes in terms of intervention delivery modes, content, target approaches, etc. Further investigation is needed, in particular with regard to anxiety.

An evaluation of digital intervention for perinatal depression and anxiety: A systematic review

“…iCBT also appears to be an effective intervention method during the perinatal period [38] . Stentzel U et al [39] emphasized that iCBT, in both clinician-guided and self-guided formats, was successful in treating perinatal depression and anxiety. The benefits of iCBT, which surpassed those of face-to-face therapy, included fewer suicide attempts, less suicidal ideation, and less self-harm [40] .…”

Maternal Perinatal-Provoked Psychological Disorders: Adverse Impact on School-Age Children, Neurodevelopment, Education, and Intervention Strategies

“…Emerging technologies and tools are helping to improve the diagnosis and treatment of psychological disorders during pregnancy. For example, mobile applications, technology-assisted therapy, and telemedicine can now deliver treatment to pregnant women with psychological distress more efficiently and cost-effectively (Stentzel et al, 2023). These tools are improving diagnosis and psychosocial interventions to mitigate psychological distress occurring during pregnancy.…”