Effects of mindfulness-based interventions on mental health among women with fetal loss: A systematic review and meta-analysis.

BACKGROUND

Mindfulness-based interventions (MBIs) have shown potential in reducing maternal negative emotions, but their effectiveness for women with fetal loss requires further investigation. This study aimed to evaluate the effects of MBIs on mental health outcomes among these women.

METHODS

Randomized controlled trials (RCTs) on MBIs for women with fetal loss were retrieved from eight databases, covering literature from inception to January 21, 2025. Outcomes included depression, anxiety, and post-traumatic growth. Risk of bias was assessed using Cochrane RoB 1.0, and meta-analyses were performed using Review Manager 5.4.

RESULTS

Ten RCTs were included. MBIs significantly improve depression (SMD=1.01, 95 %CI (0.60,1.41), p < 0.01), anxiety (SMD=1.24, 95 %CI (0.57, 1.91), p < 0.01), stress (SMD=0.99, 95 %CI (0.11, 1.86), p = 0.03) and post-traumatic growth (MD=19.67, 95 %CI (10.96, 28.38), p < 0.01) in women with fetal loss. Subgroup analyses were feasible only for depression and anxiety. MBIs significantly reduced depressive symptoms in both women with pre-existing psychological symptoms (SMD=0.85, p < 0.01) and those without (SMD=1.07, p < 0.01), with no significant difference by intervention duration (p > 0.05). For anxiety symptoms, MBIs were effective only in women without symptoms (SMD=1.57, p < 0.01). Short-duration MBIs (≤4 weeks, SMD=2.59, p < 0.01) showed greater effects than long-duration MBIs (>4 weeks, SMD=0.74, p < 0.01).

LIMITATIONS: There are few high-quality RCTs, small sample sizes, and a lack of long-term follow-up.

CONCLUSIONS

MBIs effectively improve mental health in women with fetal loss, with short-duration effects exceeding long-duration ones. These findings support the integration of MBIs into psychosocial care, particularly for women with pre-existing psychological symptoms, and highlight the need to refine intervention strategies.