Psychosocial Occupational Therapy Interventions for High-Risk Pregnancies: A Systematic Review

Abstract

Importance: High-risk pregnancies present significant psychological challenges for affected women, and psychosocial interventions may improve their mental health and quality of life. Objective: To evaluate the effectiveness of psychosocial occupational therapy interventions for managing anxiety, depression, stress, and quality of life among women with high-risk pregnancies. Data Sources: CINAHL, SocIndex, AMED, Embase via Ovid, MEDLINE in PubMed, Cochrane Library, OTseeker, and PsycINFO. Study Selection and Data Collection: This systematic review followed Cochrane Collaboration methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies included women with high-risk pregnancies (e.g., gestational diabetes, hypertensive disorders, preterm labor) and examined occupational therapy–related psychosocial interventions. Eligible studies reported outcomes for anxiety, depression, stress, or quality of life and were classified as Level 1b, 2b, or 3b evidence. Data were analyzed using narrative synthesis. Findings: Thirty-four studies met the inclusion criteria. Cognitive-based and counseling-based interventions showed moderate to strong effectiveness in reducing anxiety, depression, and stress. Emotion-based approaches had low to moderate effectiveness, and sensory-based interventions were largely ineffective. Integrated approaches, such as mindfulness-based cognitive therapy, showed mixed results. Conclusions and Relevance: Findings support integrating psychosocial interventions into occupational therapy to enhance mental health and occupational engagement for women with high-risk pregnancies. Plain-Language Summary: This study reviewed 34 studies of psychosocial interventions for women with high-risk pregnancies. Cognitive and counseling-based strategies were most effective in reducing anxiety, depression, and stress. Sensory-based approaches had little impact. These findings reinforce the role of occupational therapists in supporting mental health and inform future practice and education.