Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review
BackgroundPreconception health is essential for preventing premature birth, yet engagement in preconception care remains low. Internet-based interventions offer scalable solutions, but their effectiveness in this context is underexplored. ObjectiveThis systematic...
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JMIR Publications
2025-06-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e60690 |
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| author | Sun-Hee Kim Sun-Young Jung Jin-Hwa Park Jennie C De Gagne |
| author_facet | Sun-Hee Kim Sun-Young Jung Jin-Hwa Park Jennie C De Gagne |
| author_sort | Sun-Hee Kim |
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BackgroundPreconception health is essential for preventing premature birth, yet engagement in preconception care remains low. Internet-based interventions offer scalable solutions, but their effectiveness in this context is underexplored.
ObjectiveThis systematic review aimed to describe the characteristics and designs of studies on internet-based interventions and evaluate their effectiveness in preventing premature birth among preconceptional women of childbearing age.
MethodsWe searched MEDLINE, Embase, CINAHL, and the Cochrane Library for randomized controlled trials and quasi-experimental studies on internet-based interventions targeting premature birth prevention, covering publications up to December 2023 with no language or geographic restrictions. The search, conducted initially in February 2023 and updated in March 2024, followed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines and was registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42021277024). Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the revised Cochrane Risk of Bias tool. Due to heterogeneity in populations, interventions, and outcomes, a narrative synthesis was performed instead of a meta-analysis.
ResultsFrom 3437 articles identified across 2 searches, 9 studies were included after excluding duplicates and ineligible papers. Studies, primarily from high-income countries (eg, 4/9, 44% from the United States), varied in design (4/9, 44% randomized controlled trials; 5/9, 56% quasi-experimental) and timing (5/9, 56% post 2020). The overall risk of bias was high in 6/9 (67%) studies, with only 1/9 (11%) rated low risk. Interventions, delivered via websites (4/9, 44%), conversational agents (3/9, 33%), or other platforms, significantly improved reproductive health knowledge in 3/9 (33%) studies but showed no consistent impact on self-efficacy (no effect in 2/3 [67%] studies assessing it). Behavioral outcomes, such as folic acid use and contraception initiation, were inconsistent across 5/9 (56%) studies, with significant effects in short-term (eg, 2/9, 22%) but not long-term interventions (eg, 2/4, 50% at 12 months). No studies directly measured premature birth as an outcome.
ConclusionsInternet-based interventions showed mixed effectiveness across reproductive health outcomes pertinent to premature birth prevention, with notable gains in knowledge but limited success in altering behaviors. Given the small number of studies and the prevalent high risk of bias, these findings warrant cautious interpretation. Future research, including robust clinical trials, is essential to develop, evaluate, and disseminate effective and safe internet-based interventions for preconception care.
Trial RegistrationPROSPERO CRD42021277024; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021277024 |
| format | Article |
| id | doaj-art-c2bb742a62a14319a653f31634eaa8a5 |
| institution | DOAJ |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | JMIR Publications |
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| series | Journal of Medical Internet Research |
| spelling | doaj-art-c2bb742a62a14319a653f31634eaa8a52025-08-20T03:07:37ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-06-0127e6069010.2196/60690Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic ReviewSun-Hee Kimhttps://orcid.org/0000-0001-8518-5670Sun-Young Junghttps://orcid.org/0000-0002-4681-2536Jin-Hwa Parkhttps://orcid.org/0000-0001-8622-5734Jennie C De Gagnehttps://orcid.org/0000-0001-9814-5942 BackgroundPreconception health is essential for preventing premature birth, yet engagement in preconception care remains low. Internet-based interventions offer scalable solutions, but their effectiveness in this context is underexplored. ObjectiveThis systematic review aimed to describe the characteristics and designs of studies on internet-based interventions and evaluate their effectiveness in preventing premature birth among preconceptional women of childbearing age. MethodsWe searched MEDLINE, Embase, CINAHL, and the Cochrane Library for randomized controlled trials and quasi-experimental studies on internet-based interventions targeting premature birth prevention, covering publications up to December 2023 with no language or geographic restrictions. The search, conducted initially in February 2023 and updated in March 2024, followed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines and was registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42021277024). Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the revised Cochrane Risk of Bias tool. Due to heterogeneity in populations, interventions, and outcomes, a narrative synthesis was performed instead of a meta-analysis. ResultsFrom 3437 articles identified across 2 searches, 9 studies were included after excluding duplicates and ineligible papers. Studies, primarily from high-income countries (eg, 4/9, 44% from the United States), varied in design (4/9, 44% randomized controlled trials; 5/9, 56% quasi-experimental) and timing (5/9, 56% post 2020). The overall risk of bias was high in 6/9 (67%) studies, with only 1/9 (11%) rated low risk. Interventions, delivered via websites (4/9, 44%), conversational agents (3/9, 33%), or other platforms, significantly improved reproductive health knowledge in 3/9 (33%) studies but showed no consistent impact on self-efficacy (no effect in 2/3 [67%] studies assessing it). Behavioral outcomes, such as folic acid use and contraception initiation, were inconsistent across 5/9 (56%) studies, with significant effects in short-term (eg, 2/9, 22%) but not long-term interventions (eg, 2/4, 50% at 12 months). No studies directly measured premature birth as an outcome. ConclusionsInternet-based interventions showed mixed effectiveness across reproductive health outcomes pertinent to premature birth prevention, with notable gains in knowledge but limited success in altering behaviors. Given the small number of studies and the prevalent high risk of bias, these findings warrant cautious interpretation. Future research, including robust clinical trials, is essential to develop, evaluate, and disseminate effective and safe internet-based interventions for preconception care. Trial RegistrationPROSPERO CRD42021277024; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021277024https://www.jmir.org/2025/1/e60690 |
| spellingShingle | Sun-Hee Kim Sun-Young Jung Jin-Hwa Park Jennie C De Gagne Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review Journal of Medical Internet Research |
| title | Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review |
| title_full | Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review |
| title_fullStr | Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review |
| title_full_unstemmed | Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review |
| title_short | Internet-Based Interventions for Preventing Premature Birth in Preconceptional Women of Childbearing Age: Systematic Review |
| title_sort | internet based interventions for preventing premature birth in preconceptional women of childbearing age systematic review |
| url | https://www.jmir.org/2025/1/e60690 |
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