Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight

Annariina M. Koivu; Pieta K. Näsänen-Gilmore; Patricia J. Hunter; Yvonne Muthiani; Jaana Isojärvi; Otto Heimonen; Kalpana Bastola; Leon Csonka; Per Ashorn; Ulla Ashorn

doi:10.1016/j.ajcnut.2022.11.028

Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight

Annariina M. Koivu, Pieta K. Näsänen-Gilmore, Patricia J. Hunter, Yvonne Muthiani, Jaana Isojärvi, Otto Heimonen, Kalpana Bastola, Leon Csonka, Per Ashorn, Ulla Ashorn

Tutkimustuotos: Artikkeli › Tieteellinen › vertaisarvioitu

5 Sitaatiot (Scopus)

4 Lataukset (Pure)

Abstrakti

Background: Risk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW). Objective: This systematic search and review aims to provide a comparative evidence synthesis on the effect of eleven antenatal interventions targeted to address psychosocial risk factors on adverse birth outcomes. Methods: We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between March 2020 and May 2020. We included randomized controlled trials (RCTs) and reviews of RCTs of eleven antenatal interventions for pregnant females reporting LBW, preterm birth (PTB), small-for-gestational-age or stillbirth as outcomes. For interventions where randomization was either not feasible or unethical, we accepted non-randomized controlled studies. Results: Seven records contributed data to the quantitative estimates of the effect sizes and 23 contributed to narrative analysis. Psychosocial interventions for reducing smoking in pregnancy likely reduced the risk of LBW, and professionally provided psychosocial support for at-risk women possibly reduced the risk of PTB. Financial incentives or nicotine replacement therapy as smoking cessation aids, or virtually delivered psychosocial support did not appear to reduce the risk of adverse birth outcomes. The available evidence on these interventions was primarily from high-income countries. For other reviewed interventions (psychosocial interventions to reduce alcohol use, group based psychosocial support programs, intimate partner violence prevention interventions, antidepressant medication, and cash transfers) there was little evidence in any direction regarding the efficacy or the data was conflicting. Conclusions: Professionally provided psychosocial support during pregnancy in general and specifically as a means to reduce smoking can potentially contribute to improved newborn health. The gaps in the investments for research and implementation of psychosocial interventions should be addressed to better meet the global targets in LBW reduction.

Alkuperäiskieli	Englanti
Sivut	S148-S159
Sivumäärä	12
Julkaisu	American Journal of Clinical Nutrition
Vuosikerta	117
Numero	Supplement 2
DOI - pysyväislinkit	https://doi.org/10.1016/j.ajcnut.2022.11.028
Tila	Julkaistu - kesäk. 2023
OKM-julkaisutyyppi	A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Rahoitus

The study was funded by the Children’s Investment Fund Foundation (CIFF) , Grant Reference Number 1808-02973 . This article is published as part of a supplement sponsored by Tampere University, Faculty of Medicine and Health Technology with grant support from the Children’s Investment Fund Foundation. We included English-language studies that were relevant to population, intervention, study design and outcomes. The population of interest was pregnant females, irrespective of gestational age. The interventions were 1) psychosocial interventions, 2) nicotine replacement therapy (NRT), and 3) financial incentives to reduce smoking in pregnancy; 4) psychosocial interventions to reduce alcohol use in pregnancy; 5) health professional provided psychosocial support; 6) virtual support; 7) group program based psychosocial support; 8) antidepressant medication for pregnant women with depression; 9) intimate partner violence (IPV) prevention interventions; as well as 10) conditional and 11) unconditional cash transfers to pregnant women (search terms are listed in Supplementary data 1-11).Seven RCTs published between 2000 and 2019 and conducted primarily in the USA (4), others in Denmark, France and the UK contributed to estimates on the size of effect of nicotine replacement therapy (NRT). The NRT was provided in the form of patch, gum, lozenge or inhaler to pregnant women over 16 or 18 including women who self-identified as an ethnic minority (one study). The number of RCT (participants) reporting specific outcome data was 7 (N=2171) for LBW, 7 (N=2182) for PTB and 4 (N=1777) for SB. There was no difference on the risk of LBW (RR: 0.69 [95% CI 0.39, 1.20], PTB (RR: 0.81 [95% CI 0.59, 1.11]) or stillbirth (RR: 1.24 [95% CI 0.54, 2.84]) between the NRT group and placebo and non-placebo (behavioral support only) control. The quality of evidence was considered moderate (LBW, PTB, SB). A summary of the impact of NRT on birth outcomes is shown in Supplementary data 3.The study was funded by the Children's Investment Fund Foundation (CIFF), Grant Reference Number 1808-02973. This article is published as part of a supplement sponsored by Tampere University, Faculty of Medicine and Health Technology with grant support from the Children's Investment Fund Foundation.

Julkaisufoorumi-taso

Jufo-taso 3

!!ASJC Scopus subject areas

Medicine (miscellaneous)
Nutrition and Dietetics

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10.1016/j.ajcnut.2022.11.028

Antenatal interventionsAccepted author manuscript, 120 KBLisenssi: CC BY-NC-ND

https://urn.fi/URN:NBN:fi:tuni-202308227711Lisenssi: CC BY-NC-ND

Siteeraa tätä

Koivu, A. M., Näsänen-Gilmore, P. K., Hunter, P. J., Muthiani, Y., Isojärvi, J., Heimonen, O., Bastola, K., Csonka, L., Ashorn, P., & Ashorn, U. (2023). Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight. American Journal of Clinical Nutrition, 117(Supplement 2), S148-S159. https://doi.org/10.1016/j.ajcnut.2022.11.028

@article{34513d22044648aa9c339a77b22585b5,

title = "Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight",

abstract = "Background: Risk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW). Objective: This systematic search and review aims to provide a comparative evidence synthesis on the effect of eleven antenatal interventions targeted to address psychosocial risk factors on adverse birth outcomes. Methods: We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between March 2020 and May 2020. We included randomized controlled trials (RCTs) and reviews of RCTs of eleven antenatal interventions for pregnant females reporting LBW, preterm birth (PTB), small-for-gestational-age or stillbirth as outcomes. For interventions where randomization was either not feasible or unethical, we accepted non-randomized controlled studies. Results: Seven records contributed data to the quantitative estimates of the effect sizes and 23 contributed to narrative analysis. Psychosocial interventions for reducing smoking in pregnancy likely reduced the risk of LBW, and professionally provided psychosocial support for at-risk women possibly reduced the risk of PTB. Financial incentives or nicotine replacement therapy as smoking cessation aids, or virtually delivered psychosocial support did not appear to reduce the risk of adverse birth outcomes. The available evidence on these interventions was primarily from high-income countries. For other reviewed interventions (psychosocial interventions to reduce alcohol use, group based psychosocial support programs, intimate partner violence prevention interventions, antidepressant medication, and cash transfers) there was little evidence in any direction regarding the efficacy or the data was conflicting. Conclusions: Professionally provided psychosocial support during pregnancy in general and specifically as a means to reduce smoking can potentially contribute to improved newborn health. The gaps in the investments for research and implementation of psychosocial interventions should be addressed to better meet the global targets in LBW reduction.",

keywords = "antenatal care, Low birth weight, low- and middle-income countries, pregnancy, preterm birth, psychosocial interventions, psychosocial support, smoking",

author = "Koivu, {Annariina M.} and N{\"a}s{\"a}nen-Gilmore, {Pieta K.} and Hunter, {Patricia J.} and Yvonne Muthiani and Jaana Isoj{\"a}rvi and Otto Heimonen and Kalpana Bastola and Leon Csonka and Per Ashorn and Ulla Ashorn",

note = "Funding Information: The study was funded by the Children{\textquoteright}s Investment Fund Foundation (CIFF) , Grant Reference Number 1808-02973 . Funding Information: This article is published as part of a supplement sponsored by Tampere University, Faculty of Medicine and Health Technology with grant support from the Children{\textquoteright}s Investment Fund Foundation. Funding Information: We included English-language studies that were relevant to population, intervention, study design and outcomes. The population of interest was pregnant females, irrespective of gestational age. The interventions were 1) psychosocial interventions, 2) nicotine replacement therapy (NRT), and 3) financial incentives to reduce smoking in pregnancy; 4) psychosocial interventions to reduce alcohol use in pregnancy; 5) health professional provided psychosocial support; 6) virtual support; 7) group program based psychosocial support; 8) antidepressant medication for pregnant women with depression; 9) intimate partner violence (IPV) prevention interventions; as well as 10) conditional and 11) unconditional cash transfers to pregnant women (search terms are listed in Supplementary data 1-11).Seven RCTs published between 2000 and 2019 and conducted primarily in the USA (4), others in Denmark, France and the UK contributed to estimates on the size of effect of nicotine replacement therapy (NRT). The NRT was provided in the form of patch, gum, lozenge or inhaler to pregnant women over 16 or 18 including women who self-identified as an ethnic minority (one study). The number of RCT (participants) reporting specific outcome data was 7 (N=2171) for LBW, 7 (N=2182) for PTB and 4 (N=1777) for SB. There was no difference on the risk of LBW (RR: 0.69 [95% CI 0.39, 1.20], PTB (RR: 0.81 [95% CI 0.59, 1.11]) or stillbirth (RR: 1.24 [95% CI 0.54, 2.84]) between the NRT group and placebo and non-placebo (behavioral support only) control. The quality of evidence was considered moderate (LBW, PTB, SB). A summary of the impact of NRT on birth outcomes is shown in Supplementary data 3.The study was funded by the Children's Investment Fund Foundation (CIFF), Grant Reference Number 1808-02973. This article is published as part of a supplement sponsored by Tampere University, Faculty of Medicine and Health Technology with grant support from the Children's Investment Fund Foundation. Publisher Copyright: {\textcopyright} 2023 American Society for Nutrition",

year = "2023",

month = jun,

doi = "10.1016/j.ajcnut.2022.11.028",

language = "English",

volume = "117",

pages = "S148--S159",

number = "Supplement 2",

}

Koivu, AM, Näsänen-Gilmore, PK, Hunter, PJ, Muthiani, Y, Isojärvi, J, Heimonen, O, Bastola, K, Csonka, L, Ashorn, P & Ashorn, U 2023, 'Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight', American Journal of Clinical Nutrition, Vuosikerta 117, Nro Supplement 2, Sivut S148-S159. https://doi.org/10.1016/j.ajcnut.2022.11.028

Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight. / Koivu, Annariina M.; Näsänen-Gilmore, Pieta K.; Hunter, Patricia J. et al.
julkaisussa: American Journal of Clinical Nutrition, Vuosikerta 117, Nro Supplement 2, 06.2023, s. S148-S159.

Tutkimustuotos: Artikkeli › Tieteellinen › vertaisarvioitu

TY - JOUR

T1 - Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight

AU - Koivu, Annariina M.

AU - Näsänen-Gilmore, Pieta K.

AU - Hunter, Patricia J.

AU - Muthiani, Yvonne

AU - Isojärvi, Jaana

AU - Heimonen, Otto

AU - Bastola, Kalpana

AU - Csonka, Leon

AU - Ashorn, Per

AU - Ashorn, Ulla

N1 - Funding Information: The study was funded by the Children’s Investment Fund Foundation (CIFF) , Grant Reference Number 1808-02973 . Funding Information: This article is published as part of a supplement sponsored by Tampere University, Faculty of Medicine and Health Technology with grant support from the Children’s Investment Fund Foundation. Funding Information: We included English-language studies that were relevant to population, intervention, study design and outcomes. The population of interest was pregnant females, irrespective of gestational age. The interventions were 1) psychosocial interventions, 2) nicotine replacement therapy (NRT), and 3) financial incentives to reduce smoking in pregnancy; 4) psychosocial interventions to reduce alcohol use in pregnancy; 5) health professional provided psychosocial support; 6) virtual support; 7) group program based psychosocial support; 8) antidepressant medication for pregnant women with depression; 9) intimate partner violence (IPV) prevention interventions; as well as 10) conditional and 11) unconditional cash transfers to pregnant women (search terms are listed in Supplementary data 1-11).Seven RCTs published between 2000 and 2019 and conducted primarily in the USA (4), others in Denmark, France and the UK contributed to estimates on the size of effect of nicotine replacement therapy (NRT). The NRT was provided in the form of patch, gum, lozenge or inhaler to pregnant women over 16 or 18 including women who self-identified as an ethnic minority (one study). The number of RCT (participants) reporting specific outcome data was 7 (N=2171) for LBW, 7 (N=2182) for PTB and 4 (N=1777) for SB. There was no difference on the risk of LBW (RR: 0.69 [95% CI 0.39, 1.20], PTB (RR: 0.81 [95% CI 0.59, 1.11]) or stillbirth (RR: 1.24 [95% CI 0.54, 2.84]) between the NRT group and placebo and non-placebo (behavioral support only) control. The quality of evidence was considered moderate (LBW, PTB, SB). A summary of the impact of NRT on birth outcomes is shown in Supplementary data 3.The study was funded by the Children's Investment Fund Foundation (CIFF), Grant Reference Number 1808-02973. This article is published as part of a supplement sponsored by Tampere University, Faculty of Medicine and Health Technology with grant support from the Children's Investment Fund Foundation. Publisher Copyright: © 2023 American Society for Nutrition

PY - 2023/6

Y1 - 2023/6

N2 - Background: Risk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW). Objective: This systematic search and review aims to provide a comparative evidence synthesis on the effect of eleven antenatal interventions targeted to address psychosocial risk factors on adverse birth outcomes. Methods: We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between March 2020 and May 2020. We included randomized controlled trials (RCTs) and reviews of RCTs of eleven antenatal interventions for pregnant females reporting LBW, preterm birth (PTB), small-for-gestational-age or stillbirth as outcomes. For interventions where randomization was either not feasible or unethical, we accepted non-randomized controlled studies. Results: Seven records contributed data to the quantitative estimates of the effect sizes and 23 contributed to narrative analysis. Psychosocial interventions for reducing smoking in pregnancy likely reduced the risk of LBW, and professionally provided psychosocial support for at-risk women possibly reduced the risk of PTB. Financial incentives or nicotine replacement therapy as smoking cessation aids, or virtually delivered psychosocial support did not appear to reduce the risk of adverse birth outcomes. The available evidence on these interventions was primarily from high-income countries. For other reviewed interventions (psychosocial interventions to reduce alcohol use, group based psychosocial support programs, intimate partner violence prevention interventions, antidepressant medication, and cash transfers) there was little evidence in any direction regarding the efficacy or the data was conflicting. Conclusions: Professionally provided psychosocial support during pregnancy in general and specifically as a means to reduce smoking can potentially contribute to improved newborn health. The gaps in the investments for research and implementation of psychosocial interventions should be addressed to better meet the global targets in LBW reduction.

AB - Background: Risk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW). Objective: This systematic search and review aims to provide a comparative evidence synthesis on the effect of eleven antenatal interventions targeted to address psychosocial risk factors on adverse birth outcomes. Methods: We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between March 2020 and May 2020. We included randomized controlled trials (RCTs) and reviews of RCTs of eleven antenatal interventions for pregnant females reporting LBW, preterm birth (PTB), small-for-gestational-age or stillbirth as outcomes. For interventions where randomization was either not feasible or unethical, we accepted non-randomized controlled studies. Results: Seven records contributed data to the quantitative estimates of the effect sizes and 23 contributed to narrative analysis. Psychosocial interventions for reducing smoking in pregnancy likely reduced the risk of LBW, and professionally provided psychosocial support for at-risk women possibly reduced the risk of PTB. Financial incentives or nicotine replacement therapy as smoking cessation aids, or virtually delivered psychosocial support did not appear to reduce the risk of adverse birth outcomes. The available evidence on these interventions was primarily from high-income countries. For other reviewed interventions (psychosocial interventions to reduce alcohol use, group based psychosocial support programs, intimate partner violence prevention interventions, antidepressant medication, and cash transfers) there was little evidence in any direction regarding the efficacy or the data was conflicting. Conclusions: Professionally provided psychosocial support during pregnancy in general and specifically as a means to reduce smoking can potentially contribute to improved newborn health. The gaps in the investments for research and implementation of psychosocial interventions should be addressed to better meet the global targets in LBW reduction.

KW - antenatal care

KW - Low birth weight

KW - low- and middle-income countries

KW - pregnancy

KW - preterm birth

KW - psychosocial interventions

KW - psychosocial support

KW - smoking

U2 - 10.1016/j.ajcnut.2022.11.028

DO - 10.1016/j.ajcnut.2022.11.028

M3 - Article

AN - SCOPUS:85162030274

SN - 0002-9165

VL - 117

SP - S148-S159

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - Supplement 2

ER -

Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight

Abstrakti

Rahoitus

Julkaisufoorumi-taso

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