422 Limited benefit from telephone support for pregnant women

May 09, 2014

PEARLS 422, February 2014, written by Brian R McAvoy

Clinical question
Compared with routine care, how effective is telephone support during pregnancy and the first 6 weeks post birth?

Bottom line
Despite some encouraging findings, there was insufficient evidence to recommend routine telephone support for women accessing maternity services, as the evidence was neither strong nor consistent. Although benefits were found in terms of reduced depression scores, breastfeeding duration and increased overall satisfaction, the current trials did not provide strong enough evidence to warrant investment in resources.

Caveat
The overall methodological quality of the studies was mixed. For any single outcome there were few data and most of the results were inconclusive. Many of the trials recruited women from high-risk groups (eg, high risk of depression or smokers) and the intervention was specifically designed to address the risk factor. All but 2 of the trials were carried out in high-resource settings.

Context
Telephone communication is increasingly being accepted as a useful form of support within health care. There is some evidence telephone support may be of benefit in specific areas of maternity care, such as breastfeeding support and for women at risk of depression. There is a plethora of telephone-based interventions currently being used in maternity care. It is, therefore, timely to examine which interventions may be of benefit, which are ineffective and which may be harmful.

Cochrane Systematic Review
Lavender T et al. Telephone support for women during pregnancy and the first six weeks postpartum. Cochrane Reviews, 2013, Issue 7. Art. No.: CD009338.DOI: 10.1002/14651858. CD009338.pub2. This review contains 27 studies involving 12,256 participants

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.