Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Pregnancy Childbirth. 2023 Jul 27;23(1):541. doi: 10.1186/s12884-023-05867-0.
Antenatal education provides parents with strategies for pregnancy, childbirth, and parenthood. There is not enough evidence of the positive effect of prenatal education on childbirth and maternal outcomes. The present scoping review using a systematic approach, evaluates the effectiveness of prenatal education on fear of childbirth, pain intensity during labour, childbirth experience, and postpartum psychological health.
We used Google Scholar and systematically reviewed databases such as PubMed, Web of Science, Cochrane, Scopus, and SID (Scientific Information Database). Randomized controlled and quasi-experimental trials examining the effect of structured antenatal education and routine prenatal care compared to routine prenatal care were reviewed. The participants included pregnant women preferring a normal vaginal delivery and had no history of maternal or foetal problems. The outcomes considered in this study included fear of childbirth, pain intensity during labour, childbirth experience (as primary outcomes) and postpartum psychological health (as secondary outcomes). The grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence.
Overall, 3242 studies were examined, of which 18 were qualified for the final analysis. The meta-analysis showed that providing prenatal education and routine care compared to only routine care may decrease the fear of childbirth, postpartum depression, and pain intensity during labour. However, we found no study examining the outcome of the childbirth experience. In addition, the inconsistency of included studies prevented conducting a meta-analysis on the rest of the outcomes.
Our investigations showed that there are very few or no studies on the effect of prenatal education on outcomes such as childbirth experience, postpartum anxiety, and maternal attachment, and the existing studies on the effect of prenatal education on outcomes such as the fear of childbirth, postpartum depression, and pain intensity during labour lack sufficient quality to make definitive conclusions. Therefore, high-quality, randomized trials with a more extensive sample size are suggested to provide clear reports to make definitive decisions.
CRD42022376895.
产前教育为父母提供了妊娠、分娩和育儿的策略。目前还没有足够的证据表明产前教育对分娩和产妇结局有积极影响。本系统评价使用系统方法评估产前教育对分娩恐惧、分娩时疼痛强度、分娩体验和产后心理健康的有效性。
我们使用 Google Scholar 并系统地审查了 PubMed、Web of Science、Cochrane、Scopus 和 SID（科学信息数据库）等数据库。审查了比较结构化产前教育和常规产前护理与常规产前护理对分娩恐惧、分娩时疼痛强度、分娩体验（主要结局）和产后心理健康（次要结局）影响的随机对照试验和准实验研究。本研究纳入的参与者为选择正常阴道分娩且无母婴问题史的孕妇。本研究考虑的结局包括分娩恐惧、分娩时疼痛强度、分娩体验（作为主要结局）和产后心理健康（作为次要结局）。使用推荐评估、制定与评估分级（GRADE）方法评估证据质量。
总共检查了 3242 项研究，其中有 18 项符合最终分析标准。荟萃分析表明，与仅常规护理相比，提供产前教育和常规护理可能会降低分娩恐惧、产后抑郁和分娩时疼痛强度。然而，我们没有发现研究检查分娩体验的结局。此外，纳入研究的不一致性使得无法对其余结局进行荟萃分析。
我们的研究表明，关于产前教育对分娩体验、产后焦虑和母婴依恋等结局的影响的研究很少或没有，关于产前教育对分娩恐惧、产后抑郁和分娩时疼痛强度等结局的影响的现有研究缺乏足够的质量来得出明确的结论。因此，建议进行高质量、样本量大的随机试验，以提供明确的报告，做出明确的决策。
CRD42022376895。
