Journal of midwifery & women's health最新文献

{"title":"Open-Label Randomized Controlled Trial and Feasibility Study of an Oral Probiotic Intervention to Reduce Group B Streptococcus Colonization in Pregnant People by the Time of Birth.","authors":"Katrina Nardini, Lisa Hanson, Noelle Borders, Maharaj Singh, Anna Shields, Victoria Y Trujillo, Robyn Lawton, Emily Malloy","doi":"10.1111/jmwh.13765","DOIUrl":"https://doi.org/10.1111/jmwh.13765","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this midwife-led study was to determine the feasibility of a randomized controlled trial (RCT) of probiotics to reduce group B Streptococcus (GBS) colonization by the time of birth in healthy, GBS-positive, pregnant adults.</p><p><strong>Methods: </strong>An open-label randomized clinical trial comparing Florajen Digestion, a commercially available combination oral probiotic, with usual care (ClinicalTrials.gov NCT04721912) was conducted in a midwifery practice serving a racially and ethnically diverse population. Eligible patients who tested positive for GBS at routine third-trimester screening were offered informed consent and participation. The primary outcome was feasibility for a larger RCT, including feasibility of probiotic use among participants. Secondary outcomes were intrapartum GBS colonization and Antepartum Gastrointestinal Symptoms of Pregnancy (AP-GI-SA) scores.</p><p><strong>Results: </strong>A total of 68 participants were enrolled and randomized; 65 participants completed the study, but only 46 had intrapartum cultures collected and processed. Among the 23 pregnant individuals who were eligible but chose not to participate, 3 indicated that they did not want to take a probiotic. After an average of 14 days of the intervention, 7 of 25 (28%) participants in the probiotic group had a negative intrapartum GBS result compared with 3 of 21 (14.3%) in the control group (odds ratio, 2.33; 95% CI, 0.52-10.48). There was no difference in perinatal outcomes or AP-GI-SA scores between groups. No adverse events occurred.</p><p><strong>Discussion: </strong>The feasibility of a larger RCT was demonstrated. Challenges identified included intrapartum GBS collection and laboratory processing during the COVID-19 pandemic. The study was not powered to detect a significant difference in intrapartum GBS colonization, although a larger decrease in GBS colonization was noted among probiotic-using participants. Florajen Digestion may show efficacy in a RCT with a longer intervention period. It is possible that the probiotic intervention duration was too brief to show a reduction in gastrointestinal pregnancy symptoms.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy Burden: An Integrative Review and Dimensional Analysis of Pregnancy's Hidden Challenges.","authors":"Hannah E Kumarasamy, Felesia Bowen, Becca Billings, Patricia A Patrician","doi":"10.1111/jmwh.13759","DOIUrl":"https://doi.org/10.1111/jmwh.13759","url":null,"abstract":"<p><strong>Introduction: </strong>Outcomes surrounding childbirth have focused on survival, leaving gaps in understanding the comprehensive experience of pregnancy for the pregnant individual. Anecdotally, pregnancy and the opportunity to reproduce is often received with a celebratory response. Yet whether planned or unplanned, a wide array of burdens may exist throughout pregnancy ranging from minor inconveniences to dangerous contributions to morbidity and mortality. The experience of pregnancy is superimposed onto the physical, mental, and social reality that already exists as an individual's life and consistently accentuates aspects of stress that can lead to increased physical, mental, emotional, financial, or other burden that many health and social systems globally lack resources to support. To address this gap, this analysis sought to explore the concept of pregnancy burden.</p><p><strong>Methods: </strong>A formal search of 5 databases was conducted using integrative review methodology, with a total of 37 articles meeting inclusion criteria. To better conceptualize pregnancy burden, a dimensional analysis was then undertaken posing the research question, \"What is pregnancy burden?\"</p><p><strong>Results: </strong>The current social construction of pregnancy burden revealed multidimensional contributors to burden that were identified as both intrinsic and extrinsic, with no current definition available. Five dimensions of pregnancy burden were discovered: health, education, financial or cost, inequity, and social support. Three distinct perspectives were identified that included the pregnant person; their partners, family, or friends; and health systems or care providers. To best answer the research question and focus on the personal experience, the scope of this analysis was limited to the perspective of the pregnant individual.</p><p><strong>Discussion: </strong>The term burden is discussed and well-developed in chronic disease literature but has not been inclusive of pregnancy. This review revealed that pregnancy burden exists but remains unclassified and understudied, supporting the need for further exploration. Better understanding and valuing of the total experience of pregnancy, inclusive of burden, has the potential to improve the pregnancy experience.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Community-Centered and Antiracist Model of Whole-Person Perinatal Care: Beloved Birth Black Centering.","authors":"MariaDelSol De Ornelas, Kim G Harley, Danielle Davis, Anna Gruver, Dana Cruz Santana, Krista Hayes, Martha Tesfalul, Jyesha Wren","doi":"10.1111/jmwh.13761","DOIUrl":"https://doi.org/10.1111/jmwh.13761","url":null,"abstract":"<p><p>Beloved Birth Black Centering (Beloved) is a community-centered and antiracist model of whole-person perinatal care, created by and for Black people in Alameda County, California. In 2019, a diverse group of birth equity advocates within Oakland's public safety net health care system and public health department came together to design Beloved, following the leadership of Black midwives, public health practitioners, physicians, and doulas. Beloved centers the expertise and vision of Black women and birthing people while working to redefine Black perinatal care and transform Black birthing experiences and outcomes. Growing evidence documents Black women and birthing peoples' experiences, needs, and preferences for perinatal care. They seek to be respected, heard, believed, the autonomy to make informed decisions, and have access high quality care and supportive resources. Beloved aims to center these needs and preferences and provide whole-person perinatal care so Black women and birthing people not only survive-they thrive. Beloved bundles 5 evidence-informed strategies (referred to as the Gold-Package of Black Love) into its model of whole-person perinatal care: midwifery-led group perinatal care; racially-concordant care; wrap-around support; childbirth education; and doula services. Each evidence-informed strategy has been referenced as a need and preference by Black women and birthing people and has been found to protect against at least one pregnancy-related complication. The model aims to provide patients with holistic social support, high quality person-centered care, and antiracist approaches to care. The founders of Beloved took an asset-based approach and partnered with local community organizations and Black entrepreneurs to implement Beloved during the COVID-19 pandemic despite the inherent challenges of innovating new models in under-resourced, safety net health care systems. The model's development, implementation, theoretical underpinnings, and theory of change are described. Additionally, we discuss key lessons from implementation and future directions for research, quality improvement, sustainability, and community engagement.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-Centered Perinatal Health Care and Empowerment During Pregnancy, Birth, and Postpartum: A Cross-Sectional Mixed-Methods Analysis.","authors":"Rebecca Woofter, Renee Clarke, Prisca C Diala, Molly R Altman, Patience A Afulani","doi":"10.1111/jmwh.13760","DOIUrl":"https://doi.org/10.1111/jmwh.13760","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, Black birthing people report poor-quality health care and face adverse maternal and infant outcomes. Empowerment to advocate with health care providers could help improve outcomes for birthing people of color. The literature is, however, sparse on factors associated with empowerment in the perinatal period. We examined the association between person-centered care and feeling empowered to advocate with health care providers across the perinatal period.</p><p><strong>Methods: </strong>Data are from 265 postpartum birthing persons who completed an online survey in 2020. The survey included validated scales for Person-Centered Prenatal Care (PCPC) and Person-Centered Maternity (labor and birth) Care (PCMC), feelings of empowerment to advocate with health care providers, and an open-response question regarding empowerment. Multivariable logistic regression models and qualitative thematic analysis were conducted.</p><p><strong>Results: </strong>A majority of the sample was Black, married, had one child, had college degrees, had private insurance, and gave birth in a hospital with midwives. Overall, about 75% of the sample felt empowered to advocate with health care providers during prenatal care, birth, and postpartum. On average, participants scored 84 of 100 on the standardized PCPC scale and 90 of 100 on the standardized PCMC scale. Each one-point increase in PCPC score was associated with 11% higher odds of feeling empowered during prenatal care. Each one-point increase in PCMC score was associated with 8% higher odds of feeling empowered during both birth and postpartum. Respect and dignity drove the association between PCPC and empowerment during prenatal care, whereas communication and autonomy drove the association between PCMC and empowerment. Qualitative responses emphasized the importance of communication and respect from health care providers, autonomy, and social support from partners and doulas on empowerment.</p><p><strong>Discussion: </strong>Person-centered perinatal health care is associated with feeling empowered to advocate with health care providers during prenatal care, birth, and postpartum. Effective communication and autonomy are vital for fostering patient empowerment.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy, Birth, and Mental Health Outcomes Associated With Recent Reproductive Coercion and Intimate Partner Violence in a Crowd-Sourced National Sample.","authors":"Karen Trister Grace, Jhumka Gupta, Kathryn Fay, Tara Altay, Samantha Kanselaar, Elizabeth Miller","doi":"10.1111/jmwh.13758","DOIUrl":"https://doi.org/10.1111/jmwh.13758","url":null,"abstract":"<p><strong>Introduction: </strong>Reproductive coercion (RC) is a type of intimate partner violence (IPV) in which partners control reproductive health decision-making. More evidence is needed on peripartum health outcomes related to RC, with and without IPV, to inform interventions and health care response. The purpose of this study was to determine the impact of RC, with and without other forms of IPV, on pregnancy, birth, and mental health outcomes in a sample of people who were currently or recently pregnant.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey with people who had been pregnant in the past 2 years (N = 1941). Logistic regression models examined predicted outcomes with RC as a primary exposure and explored combinations of RC and IPV.</p><p><strong>Results: </strong>A total of 23.8% of the sample reported any past-2-years RC. RC was significantly associated with most pregnancy, birth, neonatal, and mental health outcomes. People who experienced RC alone had 2.44 higher odds of having a low birth weight newborn (95% CI, 1.04-5.71) and 1.78 higher odds of postpartum depression (95% CI, 1.03-3.08) compared with people who did not experience RC or IPV. RC with other forms of IPV had a significant impact on suicidality even controlling for depression and anxiety (odds ratio, 2.85; 95% CI, 1.94-4.18), compared with those who did not experience either.</p><p><strong>Discussion: </strong>Our findings underscore the importance of studying RC as its own construct due to its clear, independent impact on maternal health outcomes. RC, with and without physical violence, is common and detrimental to the health of pregnant and postpartum people. Greater attention to mechanisms for these associations (and the disproportionate burden on populations experiencing marginalization) is needed to interrupt and prevent harmful downstream effects.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of the Practice of the Pilates Method on Pain Perception During Pregnancy: A Quasiexperimental Study.","authors":"Carmen Feria-Ramirez, Juan D Gonzalez-Sanz, Rafael Molina-Luque, Guillermo Molina-Recio","doi":"10.1111/jmwh.13748","DOIUrl":"https://doi.org/10.1111/jmwh.13748","url":null,"abstract":"<p><strong>Introduction: </strong>The physiologic changes associated with pregnancy often result in pain, impacting the quality of life. Therefore, it is crucial to prevent and manage this pain through appropriate health care, including guidance on physical exercise. One of the currently recommended interventions is the Pilates method. However, health care professionals caring for pregnant women must have the necessary knowledge, tools, and resources to advise their patients. This study aimed to examine the impact of Pilates method practice on pregnancy-related pain.</p><p><strong>Methods: </strong>A quasiexperimental study was conducted in multiple primary care centers between November 2018 and December 2019. Participants (n = 107) self-selected to receive a Pilates program (experimental group; n = 38) or their usual care (control group; n = 69). The presence or absence of pelvic, dorsal, and abdominal pain was evaluated as an outcome measure. The results were compared after the intervention, using descriptive, bivariate, and multivariate statistics. The study was registered at ClinicalTrials.gov (NTC04431102).</p><p><strong>Results: </strong>Pilates method practice was associated with decreased presence of pelvic pain (odds ratio [OR], 2.73; 95% CI, 1.18-4.51; P = .02) and abdominal pain (OR, 5.24; 95% CI, 2.23-12.35; P < .001). No statistically significant difference was found for the presence of dorsal pain.</p><p><strong>Discussion: </strong>Pilates appears to be a promising tool for enhancing well-being during pregnancy by reducing pelvic and abdominal pain. It would be beneficial to involve other professionals trained in the Pilates method or, in the future, to train midwives to implement this intervention in birth and parenting programs within primary care.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Randomized Controlled Trial of a Multimodal Wellness Intervention for Perinatal Mental Health.","authors":"Ellen Goldstein, Mariam Keita, Christabel Koomson, Nathan Tintle, Kirby Adlam, Erin Farah, Mary Dawn Koenig","doi":"10.1111/jmwh.13754","DOIUrl":"https://doi.org/10.1111/jmwh.13754","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence has shown that pregnant women who report high rates of psychologic stress are at increased risk for perinatal complications. We conducted a pilot randomized controlled trial (RCT) of a multimodal wellness intervention (MWI) composed of motivational interviewing and mental wellness skills to examine feasibility and acceptability of MWI and to compare changes in subjective measures of psychological and socioemotional outcomes among pregnant women through early postpartum.</p><p><strong>Methods: </strong>Between March 2023 and February 2024, eligible pregnant individuals aged 18 and older, at 10 to 24 weeks' gestation, and English-speaking were recruited from a university-affiliated federally qualified health center (FQHC) in a large metropolitan area. Forty participants were randomized 1:1 to 4 weekly individual (45-60 minutes) virtual sessions of MWI or prenatal education control. Patient-reported perinatal distress and wellness indicators were interview-administered at baseline, postintervention, 2 months postintervention, and 6 weeks postpartum. This study was registered at ClinicalTrials.gov (NCT05718479).</p><p><strong>Results: </strong>The mean (SD) age of participants was 27.9 (5.7) years. Most participants identified as Black or African American (70%) pregnant women, with three-quarters being seen for prenatal services at an FQHC. The mean (SD) number of completed intervention sessions was 3.3 (1.3), with 75% of participants completing all 4 sessions. All participants reported being satisfied with the intervention, with 73% who were very satisfied and 86.7% who found the program very useful. MWI versus prenatal education demonstrated medium- to large-sized effects on reducing anxiety from mild to minimal symptoms and resulted in significantly increased health-promoting behaviors (eg, exercise, sleep, nutrition) at follow-up timepoints.</p><p><strong>Conclusions: </strong>Findings suggest that MWI was feasible and acceptable, in addition to demonstrating larger reductions in anxiety and greater increases in health-promoting behaviors compared to prenatal education among pregnant women. Further exploration of efficacy outcomes would require a larger sample size to detect more precise effects of MWI on psychological and socioemotional functioning during the perinatal period.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal Substance Use Disorder Educational Content in US Midwifery Training Programs: A Survey.","authors":"Meagan Thompson, Casey Tak, Jessica Ann Ellis, Melissa Saftner","doi":"10.1111/jmwh.13755","DOIUrl":"https://doi.org/10.1111/jmwh.13755","url":null,"abstract":"<p><strong>Introduction: </strong>Perinatal substance use disorders (PSUDs) are a leading cause of maternal mortality and morbidity during the pregnancy and postpartum periods. This study aims to assess the incorporation of PSUD training in midwifery education programs and provide actionable recommendations for enhancing midwifery training.</p><p><strong>Methods: </strong>A cross-sectional survey was administered to US certified nurse-midwifery and certified midwifery education program directors regarding the didactic and clinical education their students received.</p><p><strong>Results: </strong>There were 35 of 39 programs that responded to the survey. Findings indicate that most midwifery programs provide didactic content, but less than half of midwifery programs provide clinical experiences for their students. Most programs provide didactic content covering nicotine and tobacco cessation, perinatal alcohol use, epidemiology of substance use disorders, and screening for substance use disorders.</p><p><strong>Discussion: </strong>Program directors identified several barriers to enhanced PSUD education and clinical experience for their students, including lack of dedicated perinatal addiction clinicians, lack of faculty expertise, lack of time in the curriculum, and lack of time by faculty, among others.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider-Led Interventions to Reduce Congenital Cytomegalovirus.","authors":"Erin Trisko, Kayla Gosnell, Taneesha Douglas, Katrina Wu","doi":"10.1111/jmwh.13749","DOIUrl":"https://doi.org/10.1111/jmwh.13749","url":null,"abstract":"<p><strong>Introduction: </strong>Cytomegalovirus (CMV) infection immediately before or during pregnancy can infect a fetus transplacentally, causing congenital CMV (cCMV). cCMV can cause miscarriage, stillbirth, growth restriction, neurodevelopmental delay, hearing, and vision impairment. This integrative review examined original research to better inform health care providers on methods for reducing cCMV infections.</p><p><strong>Methods: </strong>Database searching to identify original research pertaining to cCMV prevention in CINAHL, PubMed, and Nursing and Allied Health in January 2024 produced an initial 417 initial studies. Final extraction included 34 studies that met inclusion criteria for analysis.</p><p><strong>Results: </strong>Three relevant themes emerged: education, screening, and treatment. Messaging and education focused on risk reduction as most effective for behavioral changes. Maternal screening did not predict cCMV in low-risk women; however, it did diagnose early-stage maternal infections. Initiation of treatment closer to infection diagnosis demonstrated better outcomes. The 2 main treatment options for maternal infection were valacyclovir 8 g daily orally and CMV-hyperimmunoglobulin (HIG) 100 or 200 units per kilogram via intravenous (IV) infusion at varying frequency. Research on the efficacy of valacyclovir showed reductions in the incidence of cCMV without adverse maternal effects. Reduction in neonatal transmission and adverse sequelae were more likely with the 200 units per kilogram dosing of IV administration of HIG-CMV compared with the lower dose of 100 units per kilogram.</p><p><strong>Discussion: </strong>cCMV is often overlooked and untreated. Education in a variety of formats is effective at increasing provider knowledge and reducing infection rates by influencing maternal behavior. Screening recommendations are inconsistent but can be used as a tool to identify those pregnant individuals at highest risk, which could facilitate early diagnosis and prompt treatment. Maternal administration of medications such as valacyclovir and HIG-CMV have been shown to reduce the incidence of cCMV. Treatment options for CMV infection in pregnancy and resources for patient education are available and can reduce transmission to the neonate.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Interventions During Pregnancy to Improve Breastfeeding Self-Efficacy: Systematic Review and Meta-Analysis.","authors":"Fatma Koruk, Selma Kahraman, Zeliha Turan, Hatice Nur Özgen, Burcu Beyazgül","doi":"10.1111/jmwh.13742","DOIUrl":"https://doi.org/10.1111/jmwh.13742","url":null,"abstract":"<p><strong>Introduction: </strong>Breastfeeding self-efficacy can be increased through effective interventions to improve breastfeeding rates and promote maternal and infant health. Improving breastfeeding self-efficacy in the prenatal period is important for successful breastfeeding and sustainable breastfeeding practices after birth. Although randomized controlled trials have shown that antenatal and postnatal interventions can boost breastfeeding self-efficacy, evidence is lacking on which interventions are most effective and on the key characteristics of such interventions. The purpose of this review was (1) to examine the effects of various antenatal interventions on breastfeeding self-efficacy and (2) to identify the most effective intervention.</p><p><strong>Methods: </strong>In this meta-analysis, randomized controlled trials and experimental studies were searched using 5 search engines in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols declaration guidelines. In total, 34 studies were identified, which included 4698 participants. A random effects model, subgroup analysis, and meta-regression analysis were used to pool the results.</p><p><strong>Results: </strong>During pregnancy, all types of interventions except model-based counseling provided without prior education and simulation methods have been effective in increasing breastfeeding self-efficacy (P <.05). Intervention type was the only intervention characteristic that showed statistically significant differences in effect size using the between-group heterogeneity statistic (Q_B, 13.888; P = .016). A meta-regression analysis found a significant effect of differences in intervention types across studies (heterogeneity: τ², 0.672; Q value = 662.100; df = 33; P < .001; I² = 95.016%; test for overall effect: z, 7.020; P = .001), and this difference was found to be due to model-based education and counseling, which had the largest effect size in increasing breastfeeding self-efficacy. Intervention type explained 16% of the relationship between interventions to increase breastfeeding self-efficacy during pregnancy and breastfeeding self-efficacy (r² = 0.16).</p><p><strong>Discussion: </strong>There is a relationship between the types of interventions for breastfeeding during pregnancy and breastfeeding self-efficacy. To increase breastfeeding self-efficacy during pregnancy, it is recommended that health care professionals primarily develop programs that include model-based education and counseling.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}