Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.

<h4>Introduction</h4>Pregnant and postpartum women face major psychological stressors that put them at higher risk of developing common mental disorders, such as depression and anxiety. Yet, their limited access to and uptake of traditional mental health care is inequitable, especially d...

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Autores principales:	Ammar Saad, Olivia Magwood, Tim Aubry, Qasem Alkhateeb, Syeda Shanza Hashmi, Julie Hakim, Leanne Ford, Azaad Kassam, Peter Tugwell, Kevin Pottie
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dfef4fe348b94266ad06b9a227ff40e8
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spelling	oai:doaj.org-article:dfef4fe348b94266ad06b9a227ff40e82021-12-02T20:06:06ZMobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.1932-620310.1371/journal.pone.0259474https://doaj.org/article/dfef4fe348b94266ad06b9a227ff40e82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259474https://doaj.org/toc/1932-6203<h4>Introduction</h4>Pregnant and postpartum women face major psychological stressors that put them at higher risk of developing common mental disorders, such as depression and anxiety. Yet, their limited access to and uptake of traditional mental health care is inequitable, especially during the COVID-19 pandemic. Mobile interventions emerged as a potential solution to this discontinued healthcare access, but more knowledge is needed about their effectiveness and impact on health equity. This equity-focused systematic review examined the effectiveness and equity impact of mobile interventions targeting common mental disorders among pregnant and postpartum women.<h4>Methods and results</h4>We systematically searched MEDLINE, EMBASE, PsychINFO and 3 other databases, from date of database inception and until January 2021, for experimental studies on mobile interventions targeting pregnant and postpartum women. We used pooled and narrative synthesis methods to analyze effectiveness and equity data, critically appraised the methodological rigour of included studies using Cochrane tools, and assessed the certainty of evidence using the GRADE approach. Our search identified 6148 records, of which 18 randomized and non-randomized controlled trials were included. Mobile interventions had a clinically important impact on reducing the occurrence of depression (OR = 0.51 [95% CI 0.41 to 0.64]; absolute risk reduction RD: 7.14% [95% CI 4.92 to 9.36]; p<0.001) and preventing its severity perinatally (MD = -3.07; 95% CI -4.68 to -1.46; p<0.001). Mobile cognitive behavioural therapy (CBT) was effective in managing postpartum depression (MD = -6.87; 95% CI -7.92 to -5.82; p<0.001), whereas other support-based interventions had no added benefit. Results on anxiety outcomes and utilization of care were limited. Our equity-focused analyses showed that ethnicity, age, education, and being primiparous were characteristics of influence to the effectiveness of mobile interventions.<h4>Conclusion</h4>As the COVID-19 pandemic has increased the need for virtual mental health care, mobile interventions show promise in preventing and managing common mental disorders among pregnant and postpartum women. Such interventions carry the potential to address health inequity but more rigorous research that examines patients' intersecting social identities is needed.Ammar SaadOlivia MagwoodTim AubryQasem AlkhateebSyeda Shanza HashmiJulie HakimLeanne FordAzaad KassamPeter TugwellKevin PottiePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0259474 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ammar Saad Olivia Magwood Tim Aubry Qasem Alkhateeb Syeda Shanza Hashmi Julie Hakim Leanne Ford Azaad Kassam Peter Tugwell Kevin Pottie Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.
description	<h4>Introduction</h4>Pregnant and postpartum women face major psychological stressors that put them at higher risk of developing common mental disorders, such as depression and anxiety. Yet, their limited access to and uptake of traditional mental health care is inequitable, especially during the COVID-19 pandemic. Mobile interventions emerged as a potential solution to this discontinued healthcare access, but more knowledge is needed about their effectiveness and impact on health equity. This equity-focused systematic review examined the effectiveness and equity impact of mobile interventions targeting common mental disorders among pregnant and postpartum women.<h4>Methods and results</h4>We systematically searched MEDLINE, EMBASE, PsychINFO and 3 other databases, from date of database inception and until January 2021, for experimental studies on mobile interventions targeting pregnant and postpartum women. We used pooled and narrative synthesis methods to analyze effectiveness and equity data, critically appraised the methodological rigour of included studies using Cochrane tools, and assessed the certainty of evidence using the GRADE approach. Our search identified 6148 records, of which 18 randomized and non-randomized controlled trials were included. Mobile interventions had a clinically important impact on reducing the occurrence of depression (OR = 0.51 [95% CI 0.41 to 0.64]; absolute risk reduction RD: 7.14% [95% CI 4.92 to 9.36]; p<0.001) and preventing its severity perinatally (MD = -3.07; 95% CI -4.68 to -1.46; p<0.001). Mobile cognitive behavioural therapy (CBT) was effective in managing postpartum depression (MD = -6.87; 95% CI -7.92 to -5.82; p<0.001), whereas other support-based interventions had no added benefit. Results on anxiety outcomes and utilization of care were limited. Our equity-focused analyses showed that ethnicity, age, education, and being primiparous were characteristics of influence to the effectiveness of mobile interventions.<h4>Conclusion</h4>As the COVID-19 pandemic has increased the need for virtual mental health care, mobile interventions show promise in preventing and managing common mental disorders among pregnant and postpartum women. Such interventions carry the potential to address health inequity but more rigorous research that examines patients' intersecting social identities is needed.
format	article
author	Ammar Saad Olivia Magwood Tim Aubry Qasem Alkhateeb Syeda Shanza Hashmi Julie Hakim Leanne Ford Azaad Kassam Peter Tugwell Kevin Pottie
author_facet	Ammar Saad Olivia Magwood Tim Aubry Qasem Alkhateeb Syeda Shanza Hashmi Julie Hakim Leanne Ford Azaad Kassam Peter Tugwell Kevin Pottie
author_sort	Ammar Saad
title	Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.
title_short	Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.
title_full	Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.
title_fullStr	Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.
title_full_unstemmed	Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.
title_sort	mobile interventions targeting common mental disorders among pregnant and postpartum women: an equity-focused systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/dfef4fe348b94266ad06b9a227ff40e8
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Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review.

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