The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach

Abstract Background Improving maternal self-efficacy during childbirth is a key objective of antenatal care, with evidence suggesting that nurse-led education can play a critical role in this process. However, the overall effectiveness and consistency of these interventions across delivery formats r...

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Main Authors: Huda Hamdy Mohammed, Azza Ali Abd El Hamed, Nagwa Abd El- Fadil Afefy, Nadine Alaa Sherif, Sahar Mansour Ibrahim
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03471-5
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author Huda Hamdy Mohammed
Azza Ali Abd El Hamed
Nagwa Abd El- Fadil Afefy
Nadine Alaa Sherif
Sahar Mansour Ibrahim
author_facet Huda Hamdy Mohammed
Azza Ali Abd El Hamed
Nagwa Abd El- Fadil Afefy
Nadine Alaa Sherif
Sahar Mansour Ibrahim
author_sort Huda Hamdy Mohammed
collection DOAJ
description Abstract Background Improving maternal self-efficacy during childbirth is a key objective of antenatal care, with evidence suggesting that nurse-led education can play a critical role in this process. However, the overall effectiveness and consistency of these interventions across delivery formats remain unclear. Objective To provide an evidence-based analysis of the effectiveness of nurse-led antenatal education programs on maternal childbirth self-efficacy using quantitative synthesis and subgroup comparisons. Methods A comprehensive search was conducted across six databases (PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and Embase) to identify relevant studies published from January 2000 to April 2025. Twenty studies (randomized controlled trials and quasi-experimental designs) were included. A meta-analysis was conducted to estimate the pooled effect size, assess heterogeneity, and evaluate subgroup differences by delivery format (face-to-face, digital, hybrid). Risk of bias was assessed using the ROB 2 tool, and publication bias was evaluated using funnel plot symmetry, Egger’s test, and Rosenthal’s fail-safe N. The protocol was registered with PROSPERO (CRD420251058392). Results The pooled standardized mean difference (SMD) indicated a significant moderate-to-large effect of nurse-led antenatal education on maternal self-efficacy (SMD = 0.73; 95% CI: 0.69–0.77). Subgroup analysis showed the strongest and most consistent effects for face-to-face programs, while digital interventions demonstrated comparable efficacy with greater variability. Hybrid models yielded moderate but reliable outcomes. Publication bias was not detected, and heterogeneity was moderate (I² < 60%). All included studies reported positive effects. Conclusion This evidence-based analysis confirms that nurse-led antenatal education substantially improves maternal self-efficacy across various delivery models. These findings support the integration of nurse-led programs into routine prenatal care, with the potential for digital and hybrid formats to enhance scalability and access. Future research should focus on standardizing outcome measures and evaluating long-term impacts.
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spelling doaj-art-29015b4e9d194c5f8bf9ee9b640d8a172025-08-20T04:01:56ZengBMCBMC Nursing1472-69552025-07-0124111310.1186/s12912-025-03471-5The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approachHuda Hamdy Mohammed0Azza Ali Abd El Hamed1Nagwa Abd El- Fadil Afefy2Nadine Alaa Sherif3Sahar Mansour Ibrahim4Department of of Maternal & Newborn Health Nursing, Faculty of Nursing, Cairo UniversityMaternal & Newborn Health Nursing Faculty of Nursing, Cairo UniversityMaternal & Newborn Health Nursing Faculty of Nursing, Cairo UniversityObstetrics & Gynaecology, Faculty of Medicine, Cairo UniversityMaternal & Newborn Health Nursing Faculty of Nursing, Cairo UniversityAbstract Background Improving maternal self-efficacy during childbirth is a key objective of antenatal care, with evidence suggesting that nurse-led education can play a critical role in this process. However, the overall effectiveness and consistency of these interventions across delivery formats remain unclear. Objective To provide an evidence-based analysis of the effectiveness of nurse-led antenatal education programs on maternal childbirth self-efficacy using quantitative synthesis and subgroup comparisons. Methods A comprehensive search was conducted across six databases (PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and Embase) to identify relevant studies published from January 2000 to April 2025. Twenty studies (randomized controlled trials and quasi-experimental designs) were included. A meta-analysis was conducted to estimate the pooled effect size, assess heterogeneity, and evaluate subgroup differences by delivery format (face-to-face, digital, hybrid). Risk of bias was assessed using the ROB 2 tool, and publication bias was evaluated using funnel plot symmetry, Egger’s test, and Rosenthal’s fail-safe N. The protocol was registered with PROSPERO (CRD420251058392). Results The pooled standardized mean difference (SMD) indicated a significant moderate-to-large effect of nurse-led antenatal education on maternal self-efficacy (SMD = 0.73; 95% CI: 0.69–0.77). Subgroup analysis showed the strongest and most consistent effects for face-to-face programs, while digital interventions demonstrated comparable efficacy with greater variability. Hybrid models yielded moderate but reliable outcomes. Publication bias was not detected, and heterogeneity was moderate (I² < 60%). All included studies reported positive effects. Conclusion This evidence-based analysis confirms that nurse-led antenatal education substantially improves maternal self-efficacy across various delivery models. These findings support the integration of nurse-led programs into routine prenatal care, with the potential for digital and hybrid formats to enhance scalability and access. Future research should focus on standardizing outcome measures and evaluating long-term impacts.https://doi.org/10.1186/s12912-025-03471-5Maternal self-efficacyNurse-led educationChildbirth preparationMeta-analysisDigital healthPrenatal care
spellingShingle Huda Hamdy Mohammed
Azza Ali Abd El Hamed
Nagwa Abd El- Fadil Afefy
Nadine Alaa Sherif
Sahar Mansour Ibrahim
The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach
BMC Nursing
Maternal self-efficacy
Nurse-led education
Childbirth preparation
Meta-analysis
Digital health
Prenatal care
title The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach
title_full The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach
title_fullStr The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach
title_full_unstemmed The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach
title_short The effectiveness of nurse-led antenatal education on maternal self-efficacy: an evidence-based approach
title_sort effectiveness of nurse led antenatal education on maternal self efficacy an evidence based approach
topic Maternal self-efficacy
Nurse-led education
Childbirth preparation
Meta-analysis
Digital health
Prenatal care
url https://doi.org/10.1186/s12912-025-03471-5
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