JMIR Publications

ABSTRACT

Background:

Pregnant adolescents are an especially vulnerable population at increased risk of adverse pregnancy and postpartum outcomes. With increasing access to technology, many adolescents are turning to social media and other internet sources to address their pregnancy-related concerns.

Objective:

By critically appraising relevant quantitative and qualitative studies, our objectives were to (1) understand the influence and utility of Web-based tools used by pregnant adolescents or adolescent mothers on maternal and infant outcomes, and (2) determine if the use of such Web-based tools contributed to improved maternal or infant outcomes compared to conventional approaches.

Methods:

We systematically searched PubMed, Scopus, CINAHL and PsycINFO from January 2008 to November 2020 for relevant articles written in English, Chinese, Malay or French. Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. Study quality was assessed using the Joanna Briggs Institute (JBI) instrument for qualitative and non-randomized clinical trials, the Newcastle-Ottawa Scale (NOS) for cohort or case-control studies, Cochrane Risk of Bias 2 (RoB 2) for randomized clinical trials (RCT) and Mixed Methods Appraisal Tool (MMAT) for mixed methods studies. We adopted a qualitative synthesis and presented the results in a narrative format due to the heterogenous nature of the studies.

Results:

Seven articles met the inclusion criteria and were analyzed. The majority were of low to moderate risk for bias. The research methodologies represented are varied, with one RCT, non-randomized controlled trial, prospective cohort study and mixed methods study, each, and three qualitative studies. Two studies included a control group which received conventional care. Four studies included active Web-based interventions and three described exposure to Web-based tools, including the use of social media and/or other internet content. Most studies explored maternal mental well-being (n=6), other physical and psychosocial parameters and infant outcomes. We found mixed results for all internet-based interventions or platforms. Web-based tools positively influenced treatment-seeking intentions (Intervention: 17.1%, Control: 11.5%, P = .003) and actual treatment-seeking behavior for depression among postpartum adolescents (Intervention: 14.1%, Control: 6.5%, P < .001). Conversely, readily-available information on the internet may leave adolescents with increased anxiety, with the critical difference being information curated by healthcare professionals specifically to address targeted concerns versus self-acquired data sourced from various websites.

Conclusions:

Social media interventions or Web-based tools have the potential to influence outcomes in adolescent pregnancy, but there is a need for more well-conducted studies to demonstrate the effectiveness of these Web-based, social media support programs. The vastness of the information available on the Web limits the ability of healthcare professionals to monitor or control sources of information sought by patients. Thus, it is important to create professionally-curated platforms that can be used by patients to prevent or limit exposure to potentially misleading or harmful information on the internet.