High feedback versus low feedback of prenatal ultrasound for reducing maternal anxiety and improving maternal health behaviour in pregnancy

Abstract

BACKGROUND Prenatal ultrasound is one of many techniques used in screening and diagnosis. It gives parents instant access to the images of the fetus. Receiving information promotes knowledge and understanding, but it may also increase maternal anxiety. OBJECTIVES To compare high feedback versus low feedback during prenatal ultrasound for reducing maternal anxiety and improving maternal health behaviour. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010), the Central Register of Controlled Trials (The Cochrane Library 2010, Issue 1), MEDLINE (January 1966 to 1 March 2010), and the metaRegister of Controlled Trials (mRCT) (March 2010). We handsearched citation lists of relevant publications. We did not apply any language restrictions. SELECTION CRITERIA Randomized controlled trials (RCTs) of high feedback (women can see the monitor screen and receive detailed visual and verbal explanations) versus low feedback (women can not see the monitor screen and women are given only a summary statement of the scan) during prenatal ultrasound. The primary outcome measure was maternal state anxiety. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. We have expressed results as risk ratio (RR) or mean differences, together with their 95% confidence intervals (CI). MAIN RESULTS We included four studies (365 women). Three RCTs(346 participants) reported the effect of high versus low feedback during ultrasound on state anxiety scores (mean difference 0.92, 95% CI -0.58 to 2.43). Two trials (148 participants) reported women's views of the level of feedback. They do not show that women in the high feedback groups are more likely to choose very positive adjectives to describe their feelings after the scan (RR 3.30; 95% CI 0.73 to 14.85). Women who had a high feedback during ultrasound were more likely to stop smoking during pregnancy (one trial, 129 participants; RR 2.93; 95% CI 1.25 to 6.86) and to avoid alcohol during pregnancy (one trial, 129 participants; RR 2.96; 95% CI 1.15 to 7.60). AUTHORS' CONCLUSIONS There is insufficient evidence to support either high or low feedback during a prenatal ultrasound to reduce maternal anxiety and promote health behaviour.