Psychosocial Interventions for Pregnant Women: A Systematic Review and Meta-Analysis with Implications for Informal Workers in Coastal Areas

Abstract

Background: Pregnant informal workers in coastal regions experience unique socioeconomic, occupational, geographic, and environmental vulnerabilities that significantly elevate maternal mental health risks. Despite these intersecting challenges, tailored psychosocial interventions specifically designed to support this demographic remain scarce.

Objective: This study examines the efficacy of various psychosocial interventions on maternal mental health outcomes and evaluates their pragmatic implications for vulnerable pregnant informal workers within coastal communities.

Methodology: A systematic review and meta-analysis of randomised controlled trials published between 2014 and 2024 was executed across PubMed, ScienceDirect, and Scopus, in accordance with the PRISMA 2020 guidelines. Methodological quality was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist, and pooled effects were computed using Review Manager 5.4. The study protocol was prospectively registered in PROSPERO (CRD420251137446), yielding a final sample of 32 eligible trials.

Results: The findings indicate that the meta-analysis revealed significant pooled reductions in stress and postpartum depression. However, no statistically significant effects were observed for antenatal depression or sleep quality. Furthermore, the interaction between different intervention types demonstrates that although frameworks spanned cognitive behavioural therapy, mindfulness, task-sharing, mHealth, and music therapy, no retrieved study directly targeted pregnant informal workers residing in coastal environments.

Conclusion: The study concludes that psychosocial interventions yield positive effects on specific maternal mental health outcomes, though their efficacy varies across different gestational and postpartum stages. Overcoming existing structural, occupational, and geographic barriers requires a shift towards highly accessible delivery models.

Unique Contribution: This research advances maternal health literature by providing a critical evaluation of how task-sharing frameworks and mobile-health-based (mHealth) interventions represent the most pragmatic, scalable, and adaptable models for this population, effectively mitigating both occupational barriers and geographic isolation where institutional healthcare infrastructure is limited.

Key Recommendation: Public health authorities and policymakers in coastal regions should design maternal health programmes that integrate task-sharing models and mHealth-driven psychosocial interventions. Additionally, stakeholders should implement targeted digital health initiatives to safeguard maternal-infant health and enhance healthcare accessibility for underserved informal workers.