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Review
. 2021 Nov 9:24:101631.
doi: 10.1016/j.pmedr.2021.101631. eCollection 2021 Dec.

Effective psychological therapies to improve lifestyle behaviors in (pre)pregnant women: A systematic review

M van der Windt  1 , S K M van Zundert  1 , S Schoenmakers  1 , P W Jansen  2   3 , L van Rossem  1 , R P M Steegers-Theunissen  1
Affiliations
Review

Effective psychological therapies to improve lifestyle behaviors in (pre)pregnant women: A systematic review

M van der Windt et al. Prev Med Rep. .

Abstract

Poor lifestyle behaviors impact (pre)pregnant women by affecting pregnancy outcomes and offspring health. This systematic review provides an overview of psychological therapies to support lifestyle behavior changes among (pre)pregnant women. Scientific databases were searched from their inception to 20 December 2020 for studies investigating the effects of psychological therapies on improvements in lifestyle behaviors. Studies were eligible if they included (pre)pregnant women, examined the effects of a psychological therapy on at least one lifestyle behavior and used a control group receiving usual pregnancy care or a non-psychological intervention. Lifestyle behaviors of interest were dietary intake, physical activity, smoking, alcohol consumption, drug use, body weight loss and body weight gain during pregnancy. Pregnancy complications were included as outcome measures. Motivational interviewing (MI) (n = 21), cognitive behavioral therapy (CBT) (n = 8), incentive-based contingency management (IBCM) (n = 9), mindfulness (n = 1) and hypnosis (n = 1) were investigated as lifestyle behavior interventions. The findings revealed that MI was effective in reducing (self-reported) smoking and alcohol consumption and restricting gestational weight gain (GWG). CBT was only studied as an intervention to restrict GWG and the results predominantly confirmed its effectiveness. IBCM showed the strongest effect on reducing smoking and substance use. The studies using hypnosis or mindfulness to reduce smoking or restrict GWG, respectively, showed no associations. The use of psychological therapies to improve lifestyle behaviors among (pre)pregnant women is new and the scientific proof is promising. Before wide implementation is legitimated, more evidence is needed on the consequences of lifestyle change for pregnancy outcomes.

Keywords: Lifestyle behavior; Nutrition; Pregnancy; Psychological therapy; Substance use.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of studies included in the current systematic review.
Fig. 2
Fig. 2
Forest plot of relative risk ratios of included studies on a logarithmic scale QS: ErasmusAGE quality assessment score; GWG: gestational weight gain; MI/MET: motivational interviewing/motivational enhancement therapy; BT: (incentive-based) behavioral therapy; CBT: cognitive behavioral therapy; OW: overweight; OB: obese; *P-value < 0.05.
See this image and copyright information in PMC

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