Health Screening and Non-Pharmacological Interventions in Antenatal Care for Pregnant Women: A Systematic Review

Authors

  • Susi Irianti Universitas Diponegoro
  • Mirza Fathan Fuadi Universitas Diponegoro
  • Sri Ratna Ningsih Universitas Diponegoro
  • Indah Puspitasari Universitas Diponegoro
  • Sri Achadi Nugraheni Universitas Diponegoro

Keywords:

antenatal screening, electronic health records, non-pharmacological interventions, perinatal mental health, primary health care

Abstract

Perinatal mental health disorders represent a significant global public health challenge, contributing directly to the risks of preeclampsia, preterm birth, and impaired fetal cognitive development. Globally, the prevalence of perinatal depression was estimated at 11.9 percent; however, in Indonesia, maternal anxiety rates were remarkably high, reaching 43.2 percent. This study aimed to analyze early detection strategies and non-pharmacological interventions that can be directly integrated into routine antenatal care. This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol by searching the literature on Scopus and PubMed databases. Inclusion criteria include peer-reviewed studies for the period 2020–2025 that focus on the prevalence, screening, and non-pharmacological interventions of pregnant women's mental health. The methodological quality of the study was assessed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Out of a total of 5,206 articles identified, 11 medium to high quality articles were selected for analysis. The findings indicated that the use of validated screening instruments and digital innovations, such as artificial intelligence, can accurately predict depression risk. Mindfulness interventions are effective for daily stress regulation, while cognitive behavioral therapy remains the primary standard for more severe clinical cases. This study emphasized the vital importance of digitalizing screening instruments integrated with electronic health records and enhancing the competence of midwives as mental health facilitators to reduce maternal morbidity nationwide.

Downloads

Download data is not yet available.

References

Akkineni, R., Ganjekar, S., Satyanarayana, V., Kondapuram, N., Tiwari, K., Medisetti, S., Padmaja, S., Karnan, R. V., & Chandra, P. S. (2025). The impact of perinatal mental health training on knowledge and practice of primary care physicians: a systems strengthening initiative in Telangana, India. BMC Primary Care, 26(1). https://doi.org/10.1186/s12875-025-02782-5

Aljoudi, M. N., Ejheisheh, M. A., Aqtam, I., Ayed, A., & Batran, A. (2025a). Prevalence of depression and associated factors among critically ill pregnant women in Palestine. BMC Psychology, 13(1). https://doi.org/10.1186/s40359-025-02698-w

Aljoudi, M. N., Ejheisheh, M. A., Aqtam, I., Ayed, A., & Batran, A. (2025b). Prevalence of depression and associated factors among critically ill pregnant women in Palestine. BMC Psychology, 13(1). https://doi.org/10.1186/s40359-025-02698-w

Askari, N., Gupta, R., Hussain-Shamsy, N., Barker, L. C., Champagne, T., Lam, R. W., Bishop, K., Pirmohamed, J., Michalowska, M., Shah, V., Katzman, H., Jalan, A., Shanmuganathan, A., Wang, V., & Vigod, S. N. (2025a). Electronic Measurement-based care (eMBC) for perinatal depression and anxiety: a pilot randomized controlled trial. BMC Psychiatry, 25(1). https://doi.org/10.1186/s12888-025-06876-3

Askari, N., Gupta, R., Hussain-Shamsy, N., Barker, L. C., Champagne, T., Lam, R. W., Bishop, K., Pirmohamed, J., Michalowska, M., Shah, V., Katzman, H., Jalan, A., Shanmuganathan, A., Wang, V., & Vigod, S. N. (2025b). Electronic Measurement-based care (eMBC) for perinatal depression and anxiety: a pilot randomized controlled trial. BMC Psychiatry, 25(1). https://doi.org/10.1186/s12888-025-06876-3

Bante, A., Mersha, A., Zerdo, Z., Wassihun, B., & Yeheyis, T. (2021). Comorbid anxiety and depression: Prevalence and associated factors among pregnant women in Arba Minch zuria district, Gamo zone, southern Ethiopia. PLoS ONE, 16(3 March). https://doi.org/10.1371/journal.pone.0248331

Bayat, A., Amiri-Farahani, L., Soleimani, M., Eshraghi, N., & Haghani, S. (2021). Effect of short-term psychological intervention on anxiety of pregnant women with positive screening results for chromosomal disorders: a randomized controlled trial. BMC Pregnancy and Childbirth, 21(1). https://doi.org/10.1186/s12884-021-04206-5

Boran, P., Dönmez, M., Barış, E., Us, M. C., Altaş, Z. M., Nisar, A., Atif, N., Sikander, S., Hıdıroğlu, S., Save, D., & Rahman, A. (2023). Delivering the Thinking Healthy Programme as a universal group intervention integrated into routine antenatal care: a randomized-controlled pilot study. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-022-04499-6

Canfield, S. M., Canada, K. E., Rolbiecki, A. J., & Petroski, G. F. (2023a). Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-06031-4

Canfield, S. M., Canada, K. E., Rolbiecki, A. J., & Petroski, G. F. (2023b). Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-06031-4

Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. H. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry, 15(3), 245–258. https://doi.org/10.1002/wps.20346

Cuncannon, A., Seitz, K., Brar, A. S., & Dosani, A. (2024). Peer counseling for perinatal depression in low- and middle-income countries: A scoping review. In Global Mental Health (Vol. 11). Cambridge University Press. https://doi.org/10.1017/gmh.2024.73

Dadi, A. F., Miller, E. R., & Mwanri, L. (2020). Antenatal depression and its association with adverse birth outcomes in low and middleincome countries: A systematic review and meta-analysis. In PLoS ONE (Vol. 15, Number 1). Public Library of Science. https://doi.org/10.1371/journal.pone.0227323

Dubreucq, M., Dupont, C., Thiollier, M., Tebeka, S., Fourneret, P., Leboyer, M., Viaux-Savelon, S., Massoubre, C., & Dubreucq, J. (2025). Improving education in perinatal mental health, a participatory qualitative analysis. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-04781-z

Fatemi, A., Nasiri-Amiri, F., Faramarzi, M., Chehrazi, M., Rad, H. A., & Pahlavan, Z. (2023a). Comparing the effectiveness of virtual and semi-attendance Stress Inoculation Training [SIT] techniques in improving the symptoms of anxiety, depression, and stress of pregnant women with psychological distress: a multicenter randomized controlled trial. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-05650-1

Fatemi, A., Nasiri-Amiri, F., Faramarzi, M., Chehrazi, M., Rad, H. A., & Pahlavan, Z. (2023b). Comparing the effectiveness of virtual and semi-attendance Stress Inoculation Training [SIT] techniques in improving the symptoms of anxiety, depression, and stress of pregnant women with psychological distress: a multicenter randomized controlled trial. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-05650-1

Gross, J. J. (2015). Emotion Regulation: Current Status and Future Prospects. Psychological Inquiry, 26(1), 1–26. https://doi.org/10.1080/1047840X.2014.940781

Guille, C., Henrich, N., Brinson, A. K., & Jahnke, H. R. (2024). Improving the Management of Maternal Mental Health with Digital Health Care. Psych Res Clin Pract, 6, 23–32. https://doi.org/10.1176/appi

Hameed, W., Katiyar, J., & Avan, B. I. (2024). Optimising Perinatal Mental Health: Implementation Framework for Integrating Interventions into Primary Healthcare Systems. Mental Health and Prevention, 35. https://doi.org/10.1016/j.mhp.2024.200356

Hankin, B. L., Demers, C. H., Hennessey, E. M. P., Perzow, S. E. D., Curran, M. C., Gallop, R. J., Hoffman, M. C., & Davis, E. P. (2023). Effect of Brief Interpersonal Therapy on Depression during Pregnancy: A Randomized Clinical Trial. JAMA Psychiatry, 80(6), 539–547. https://doi.org/10.1001/jamapsychiatry.2023.0702

Hassdenteufel, K., Müller, M., Abele, H., Brucker, S. Y., Graf, J., Zipfel, S., Bauer, A., Jakubowski, P., Pauluschke-Fröhlich, J., Wallwiener, M., & Wallwiener, S. (2023a). Using an Electronic Mindfulness-based Intervention (eMBI) to improve maternal mental health during pregnancy: Results from a randomized controlled trial. Psychiatry Research, 330. https://doi.org/10.1016/j.psychres.2023.115599

Hassdenteufel, K., Müller, M., Abele, H., Brucker, S. Y., Graf, J., Zipfel, S., Bauer, A., Jakubowski, P., Pauluschke-Fröhlich, J., Wallwiener, M., & Wallwiener, S. (2023b). Using an Electronic Mindfulness-based Intervention (eMBI) to improve maternal mental health during pregnancy: Results from a randomized controlled trial. Psychiatry Research, 330. https://doi.org/10.1016/j.psychres.2023.115599

Hassdenteufel, K., Müller, M., Abele, H., Brucker, S. Y., Graf, J., Zipfel, S., Bauer, A., Jakubowski, P., Pauluschke-Fröhlich, J., Wallwiener, M., & Wallwiener, S. (2023c). Using an Electronic Mindfulness-based Intervention (eMBI) to improve maternal mental health during pregnancy: Results from a randomized controlled trial. Psychiatry Research, 330. https://doi.org/10.1016/j.psychres.2023.115599

Howard, L. M. (2020). Perinatal mental health: a review of progress and challenges.

Hua, G., Yue, K., Zhu, Y., Yang, F., & Zhou, M. (2025a). Different psychological interventions for perinatal depression: a systematic review and meta-analysis of randomized controlled trials. In BMC Psychiatry (Vol. 25, Number 1). BioMed Central Ltd. https://doi.org/10.1186/s12888-025-07462-3

Hua, G., Yue, K., Zhu, Y., Yang, F., & Zhou, M. (2025b). Different psychological interventions for perinatal depression: a systematic review and meta-analysis of randomized controlled trials. In BMC Psychiatry (Vol. 25, Number 1). BioMed Central Ltd. https://doi.org/10.1186/s12888-025-07462-3

Kementerian Kesehatan Buku Kesehatan Ibu dan Anak Katalog Dalam Terbitan Kementerian Kesehatan RI, I. R. (n.d.). Buku KIA Kesehatan Ibu dan Anak.

Krishnamurti, T., Rodriguez, S., Wilder, B., Gopalan, P., & Simhan, H. N. (2024a). Predicting first time depression onset in pregnancy: applying machine learning methods to patient-reported data. Archives of Women’s Mental Health, 27(6), 1019–1031. https://doi.org/10.1007/s00737-024-01474-w

Krishnamurti, T., Rodriguez, S., Wilder, B., Gopalan, P., & Simhan, H. N. (2024b). Predicting first time depression onset in pregnancy: applying machine learning methods to patient-reported data. Archives of Women’s Mental Health, 27(6), 1019–1031. https://doi.org/10.1007/s00737-024-01474-w

Kwok, W. H., Zhang, Y., & Wang, G. (2024). Artificial intelligence in perinatal mental health research: A scoping review. In Computers in Biology and Medicine (Vol. 177). Elsevier Ltd. https://doi.org/10.1016/j.compbiomed.2024.108685

Levis, B., Negeri, Z., Sun, Y., Benedetti, A., & Thombs, B. D. (2020). Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: Systematic review and meta-analysis of individual participant data. In The BMJ (Vol. 371). BMJ Publishing Group. https://doi.org/10.1136/bmj.m4022

Linde, K., Treml, J., Lehnig, F., Nagl, M., Stepan, H., & Kersting, A. (2025). Maternal mental health: A longitudinal study of depression and anxiety across pregnancy and postpartum. Midwifery, 149. https://doi.org/10.1016/j.midw.2025.104571

Loughnan, S. A., Gautam, R., Silverio, S. A., Boyle, F. M., Cassidy, J., Ellwood, D., Homer, C., Horey, D., Leisher, S. H., De Montigny, F., Murphy, M., O’Donoghue, K., Quigley, P., Ravaldi, C., Sandall, J., Storey, C., Vannacci, A., Wilson, A. N., & Flenady, V. (2022). Multicountry study protocol of COCOON: COntinuing Care in COVID-19 Outbreak global survey of New, expectant, and bereaved parent experiences. BMJ Open, 12(9). https://doi.org/10.1136/bmjopen-2022-061550

Maulina, R., Khuzaiyah, S., Setyaningrum, A. C., Sari, A. N., Novika, R. G. H., Wahidah, N. J., Nurhidayati, S., Maulida, L. F., & Tursina, E. (2025). First to Listen, Last to Be Trained: A Pathway Analysis of Midwives’ Role in Perinatal Mental Health in Indonesia. Jurnal Kesehatan, 16(2), 131–143. https://doi.org/10.35730/jk.v16i2.1330

Nillni, Y. I., Horenstein, A., McClendon, J., Duke, C. C., Sawdy, M., & Galovski, T. E. (2023). The impact of perceived everyday discrimination and income on racial and ethnic disparities in PTSD, depression, and anxiety among veterans. PLoS ONE, 18(9 September). https://doi.org/10.1371/journal.pone.0291965

Nuryati, T., & Amir, Y. (2022). MENTAL HEALTH PROBLEMS OF PREGNANT WOMEN, THE CAUSES, AND THE NEED FOR SOCIAL SUPPORT. Jurnal Biometrika Dan Kependudukan, 11(1), 80–88. https://doi.org/10.20473/jbk.v11i1.2022.80-88

O’Mahen, H. A., Ramchandani, P. G., King, D. X., Lee-Carbon, L., Wilkinson, E. L., Thompson-Booth, C., Ericksen, J., Milgrom, J., Dunkley-Bent, J., Halligan, S. L., & Fearon, P. (2022). Adapting and testing a brief intervention to reduce maternal anxiety during pregnancy (ACORN): report of a feasibility randomized controlled trial. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03737-1

O’Mahen, H., Howard, L., Sharp, H., Davey, A., Fisher, L., Gurol-Urganci, I., Heslin, M., Langham, J., Makinde, E., Tassie, E., Vitoratou, S., Brook, J., Collins, G., McCree, C., Pasupathy, D., Pickles, A., Morgan-Trimmer, S., Wong, G., Atmore, K., … van der Meulen, J. (2025). Effectiveness and cost-effectiveness of community perinatal mental health services on access, experience, recovery/relapse and obstetric and neonate outcomes: the ESMI-II mixed-methods study. Health and Social Care Delivery Research, 13(38), 1–92. https://doi.org/10.3310/RRAP0011

Pan, W. L., Lin, L. C., Kuo, L. Y., Chiu, M. J., & Ling, P. Y. (2023a). Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother–infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-05873-2

Pan, W. L., Lin, L. C., Kuo, L. Y., Chiu, M. J., & Ling, P. Y. (2023b). Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother–infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-05873-2

Pascuzzi, L., Heslop, K., Skouteris, H., Freeman, N., Leefhelm, E., & Bradfield, Z. (2025). A scoping review of interventions designed to optimize perinatal mental health and emotional wellbeing. In Mental Health and Prevention (Vol. 38). Elsevier GmbH. https://doi.org/10.1016/j.mhp.2025.200419

Prina, E., Ceccarelli, C., Abdulmalik, J. O., Amaddeo, F., Cadorin, C., Papola, D., Tol, W. A., Lund, C., Barbui, C., & Purgato, M. (2023). Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis. In International Journal of Social Psychiatry (Vol. 69, Number 7, pp. 1578–1591). SAGE Publications Ltd. https://doi.org/10.1177/00207640231174451

Republik Indonesia. (2023). Undang-Undang Republik Indonesia Nomor 17 Tahun 2023 tentang Kesehatan.

Silverwood, V., Bullock, L., Jordan, J., Turner, K., Chew-Graham, C. A., Kingstone, T., & Dawson, S. (2023). Non-pharmacological interventions for the management of perinatal anxiety in primary care: a meta-review of systematic reviews. In BJGP Open (Vol. 7, Number 3). Royal College of General Practitioners. https://doi.org/10.3399/BJGPO.2023.0022

Undang-Undang No. 14. (2014). Undang-Undang Republik Indonesia Nomor 18 Tahun 2014 Tentang Kesehatan Jiwa.

Undang-Undang Nomor 4. (2019). Undang-Undang Republik Indonesia Nomor 4 Tahun 2019 Tentang Kebidanan.

Waqas, A., Koukab, A., Meraj, H., Dua, T., Chowdhary, N., Fatima, B., & Rahman, A. (2022). Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03694-9

Wilson, C. A., Bublitz, M., Chandra, P., Hanley, S., Honikman, S., Kittel-Schneider, S., Rückl, S. C. Z., Leahy-Warren, P., & Byatt, N. (2024). A global perspective: Access to mental health care for perinatal populations. Seminars in Perinatology, 48(6). https://doi.org/10.1016/j.semperi.2024.151942

Woody, C. A., Ferrari, A. J., Siskind, D. J., Whiteford, H. A., & Harris, M. G. (2017). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. In Journal of Affective Disorders (Vol. 219, pp. 86–92). Elsevier B.V. https://doi.org/10.1016/j.jad.2017.05.003

Downloads

Published

2026-04-15

How to Cite

Irianti, S., Fuadi, M. F., Ningsih, S. R., Puspitasari, I., & Nugraheni, S. A. (2026). Health Screening and Non-Pharmacological Interventions in Antenatal Care for Pregnant Women: A Systematic Review. Faletehan Health Journal, 13(01), 118–131. Retrieved from https://journal.lppm-stikesfa.ac.id/index.php/FHJ/article/view/908

Issue

Vol. 13 No. 01 (2026): Faletehan Health Journal, Maret 2026

Section

Kebidanan

License

Copyright (c) 2026 Susi Irianti, Mirza Fathan Fuadi, Sri Ratna Ningsih, Indah Puspitasari, Sri Achadi Nugraheni

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors retain copyright and grant the journal the right of first publication. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original author and source are properly cited.