Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological…
I'm not in crisis, but pregnancy is hard on me — is there a structured psychological programme in antenatal care I could join now, rather than waiting until I meet a threshold for treatment?
Top of the evidence hierarchy, independently funded. how we score evidence
Caveat on this rating: Only 12 trials, several rated at high risk of bias by the authors' own Cochrane assessment, and the anxiety and stress estimates rest on four and five studies respectively. Too few trials reported partner or infant outcomes to say anything about them.
Twelve randomised controlled trials of psychological interventions offered to unselected pregnant women — not just those already at risk — covering 2,559 participants, found a moderate benefit on overall maternal distress (d=0.52) and on depressive symptoms (d=0.50) compared with routine care. The effect on anxiety was smaller (d=0.30) and based on only four trials. Type, timing, and delivery mode of the intervention did not change the result.
Worth asking
I'm not in crisis, but pregnancy is hard on me — is there a structured psychological programme in antenatal care I could join now, rather than waiting until I meet a threshold for treatment?
What to watch for
Evidence quality tells you whether to trust the finding — not whether the treatment is safe. These are the risks this research reports.
- Fertility & pregnancy risk
Source
Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological interventions. — Missler M, Donker T, Beijers R, et al. (2021)
Indexed peer-reviewed journal
Read the source: https://doi.org/10.1186/s12884-021-03752-2
DOI: 10.1186/s12884-021-03752-2
How this was scored
- Study design
- Meta-analysis of randomised trials
- Funding
- Independently funded
- Published in
- Indexed peer-reviewed journal
- Sample size
- 2,559
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 91 out of 100 on our published rubric. One caveat travels with that badge: Only 12 trials, several rated at high risk of bias by the authors' own Cochrane assessment, and the anxiety and stress estimates rest on four and five studies respectively. Too few trials reported partner or infant outcomes to say anything about them. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological interventions. — Missler M, Donker T, Beijers R, et al. (2021). Published in: Indexed peer-reviewed journal. DOI: 10.1186/s12884-021-03752-2. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Meta-analysis of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.