BACKGROUND
Preconception health is essential for preventing premature birth, yet engagement in preconception care remains low. Despite the development of several internet-based interventions post-COVID-19, a thorough evaluation of their effectiveness in enhancing preconception care and preventing premature births is necessary.
OBJECTIVE
This systematic review aims to assess the study designs and evaluate the effectiveness of internet-based interventions in preventing premature birth among preconceptional women of childbearing age.
METHODS
We conducted a comprehensive search of MEDLINE, Embase, CINAHL, and Cochrane Library databases to identify randomized trials and quasi-experimental studies on internet-based interventions for preventing premature birth. The search was global and included studies published up to December 2023, without language or geographic restrictions. Two authors independently assessed the risk of bias using the revised Cochrane RoB tool (RoB 2), adhering to PRISMA guidelines. A meta-analysis was not conducted due to heterogeneity in populations, measurements, and interventions.
RESULTS
Eleven articles were included, with varying study approaches. The overall risk of bias was high in most studies. Interventions improved knowledge of reproductive health but had no significant effect on self-efficacy related to preconception health promotion. While some behavioral changes to reduce preconception care risks were effectively promoted, impacts on folic acid use, contraception initiation, and dual method use were inconsistent. Furthermore, there were no significant reductions in sexually transmitted infections or unplanned pregnancies.
CONCLUSIONS
Internet-based interventions showed mixed effectiveness across different reproductive health outcomes, with general ineffectiveness in improving reproductive health status. The results, derived from a limited number of studies with a high risk of bias, suggest a need for caution in their application. Future research, including robust clinical trials, is vital to develop, evaluate, and disseminate effective and safe internet-based interventions for preconception care.
CLINICALTRIAL
PROSPERO CRD42021277024; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021277024