Effectiveness of birth preparedness interventions on maternal and neonatal outcomes in low- and middle-income countries: A systematic review and meta-analysis

Abstract

Aim: We aimed to assess the impact of birth preparedness interventions among pregnant women on the improvement of their maternal and neonatal outcomes in low- and middle-income countries. Methods: Randomized controlled trials from 2007 to 2023 that assessed birth preparedness interventions for pregnant women living in such countries were reviewed after searching on PubMed, CENTRAL, Embase, and CINAHL databases. This systematic review followed the Preferred Reporting Items for the Systematic Reviews and Meta-Analysis standards. The database searches yielded 7405 articles. Nine trials were eligible for inclusion. Results: The meta-analysis revealed a statistically significant variation in perinatal mortality (participants = 3573; studies = 2; risk ratio = 0.58; 95% confidence interval = [0.47, 0.73]; I² = 0%, moderate certainty of evidence) and a significant difference in the initiation of breastfeeding (participants = 8743; studies = 3; risk ratio = 1.89; 95% confidence interval [CI] = [1.50, 2.39]; I² = 96%, low certainty of evidence). Conclusion: Our systematic review showed that birth preparedness interventions significantly reduced perinatal mortality and increased breastfeeding initiation, as well as produced a positive impact on infant birth weight (grams) and age of gestation at birth (weeks). Future randomized controlled trials on birth preparedness interventions should be conducted and effectively promoted to enhance the health of mothers and neonates in low- and middle-income countries.