Non-pharmacological interventions for the management of perinatal anxiety in primary care: A meta-review of systematic reviews

Background Perinatal anxiety (PNA), anxiety that occurs during pregnancy and/or up to 12 months post-partum, is estimated to affect up to 21% of women, and may impact negatively on mothers, children and their families. The National Institute for Health and Care Excellence has called for further research around non-pharmacological interventions in primary care for PNA.

Aim To summarise the available international evidence on non-pharmacological interventions for women with PNA in a primary care population.

Design & setting A meta-review of systematic reviews (SRs) with narrative synthesis was performed following PRISMA guidance.

Method Systematic literature searches were conducted in eleven health-related databases up to June 2022. Titles, abstracts and full text articles were dual-screened against pre-defined eligibility criteria. A variety of study designs are included. Data were extracted about study participants, intervention design and context. Quality appraisal was performed using the AMSTAR2 tool. A patient and public involvement group informed and contributed towards this meta-review.

Results 24 SRs included in the meta-review. Interventions were grouped into six categories for analysis purposes: psychological therapies, mind-body activities, emotional support from healthcare professionals, peer support, educational activities and alternative/complementary therapies.

Conclusion In addition to pharmacological and psychological therapies, this meta-review demonstrates that there are many more options available for women to choose from which might be effective to manage their PNA. Evidence gaps are present in several intervention categories. Primary care clinicians and commissioners should endeavour to provide patients with a choice of these management options, promoting individual choice and patient-centred care.