Perspectives on antenatal education associated with pregnancy outcomes: Systematic review and meta-analysis

Kwan Hong, Hari Hwang, Helin Han, Jaeeun Chae, Jimi Choi, Yujin Jeong, Juneyoung Lee, Kyung Ju Lee

    Research output: Contribution to journalReview articlepeer-review

    47 Citations (Scopus)


    Background: Many studies on the relation between maternal health and infant health, including the effect of structured antenatal education, have been published and expanded over the years. Aim: Investigate the impact of various antenatal education programmes on pregnancy outcomes to aid the development of future guidelines related to maternal and foetal health. Methods: Bibliographic databases (Cochrane, PubMed, EMBASE, CINAHL, Korean Studies Information Service System) were searched up to November 2018, following the PICO criteria: population (pregnant women), intervention (antenatal education), comparison (not specified), and outcome (maternal and foetal outcome including physical or mental health components). Findings: We included 23 eligible studies consisting of 14 controlled trials and 9 observational studies. The maternal physical outcomes depending on participation in antenatal education were not significantly different; however, the caesarean birth rate was lower in the antenatal education group (relative risk, RR, 0.90; 95% confidence interval, CI, 0.82–0.99), as was the use of epidural anaesthesia (RR, 0.84; 95% CI, 0.74–0.96). The maternal mental health outcomes of stress and self-efficacy significantly improved in the antenatal education group, although there was no difference in anxiety and depression. The foetal outcomes of birth weight or gestational age at birth were also not different between the groups. Conclusion: Antenatal education can reduce maternal stress, improve self-efficacy, lower the caesarean birth rate, and decrease the use of epidural anaesthesia; however, there is limited evidence of its effects on maternal or foetal physical outcomes. Therefore, antenatal education should be standardised to elucidate its actual mental and physical health effects.

    Original languageEnglish
    Pages (from-to)219-230
    Number of pages12
    JournalWomen and Birth
    Issue number3
    Publication statusPublished - 2021 May

    Bibliographical note

    Publisher Copyright:
    © 2020 Australian College of Midwives


    • Antenatal care
    • Antenatal education
    • Foetal outcome
    • Maternal outcome
    • Pregnancy outcome

    ASJC Scopus subject areas

    • Obstetrics and Gynaecology
    • Maternity and Midwifery


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