Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents : a systematic review
Date
2020-05-14
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Pregnancy and parenthood are known to be high-risk times for mental health. However, less is
known about the mental health of pregnant adolescents or adolescent parents. Despite the substantial literature on
the risks associated with adolescent pregnancy, there is limited evidence on best practices for preventing poor
mental health in this vulnerable group. This systematic review therefore aimed to identify whether psychosocial
interventions can effectively promote positive mental health and prevent mental health conditions in pregnant and
parenting adolescents.
Methods: We used the standardized systematic review methodology based on the process outlined in the World
Health Organization’s Handbook for Guidelines Development. This review focused on randomized controlled trials of
preventive psychosocial interventions to promote the mental health of pregnant and parenting adolescents, as
compared to treatment as usual. We searched PubMed/Medline, PsycINFO, ERIC, EMBASE and ASSIA databases, as
well as reference lists of relevant articles, grey literature, and consultation with experts in the field. GRADE was used
to assess the quality of evidence.
Results: We included 17 eligible studies (n = 3245 participants). Interventions had small to moderate, beneficial
effects on positive mental health (SMD = 0.35, very low quality evidence), and moderate beneficial effects on school
attendance (SMD = 0.64, high quality evidence). There was limited evidence for the effectiveness of psychosocial
interventions on mental health disorders including depression and anxiety, substance use, risky sexual and reproductive
health behaviors, adherence to antenatal and postnatal care, and parenting skills. There were no available data for outcomes
on self-harm and suicide; aggressive, disruptive, and oppositional behaviors; or exposure to intimate partner violence. Only
two studies included adolescent fathers. No studies were based in low- or middle-income countries. Conclusion: Despite the encouraging findings in terms of effects on positive mental health and school attendance
outcomes, there is a critical evidence gap related to the effectiveness of psychosocial interventions for improving
mental health, preventing disorders, self-harm, and other risk behaviors among pregnant and parenting adolescents.
There is an urgent need to adapt and design new psychosocial interventions that can be pilot-tested and scaled with
pregnant adolescents and adolescent parents and their extended networks, particularly in low-income settings.
Keywords: Adolescent pregnancy, Adolescent parenthood, Mental health, Psychosocial interventions, Systematic
review, Meta-analysis
Description
CITATION: Laurenzi, C. A., et al. 2020. Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents : a systematic review. Reproductive Health, 17:65, doi:10.1186/s12978-020-00913-y.
The original publication is available at https://reproductive-health-journal.biomedcentral.com
The original publication is available at https://reproductive-health-journal.biomedcentral.com
Keywords
Pregnant teenagers -- Mental health, Parenting -- Psychological aspects, Systematic reviews (Medical research)
Citation
Laurenzi, C. A., et al. 2020. Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents : a systematic review. Reproductive Health, 17:65, doi:10.1186/s12978-020-00913-y