Health Counseling for Self-Care in Adolescent and Young Women During Pregnancy and Motherhood: A Systematic Review and Meta-Analysis

This study aimed to evaluate the effectiveness of counseling and educational interventions delivered during pregnancy and early motherhood in promoting maternal health knowledge, self-care behaviors, and related health outcomes among adolescent and young women. A systematic review of randomized controlled trials and quasi-experimental studies published in English or Spanish was conducted using Medline, Web of Science, Scopus, Cinahl, and the Cochrane Library. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools, and risk of bias was evaluated using the Risk-of-Bias 2 and ROBINS-I tools. Data were synthesized narratively and in tables. When comparable outcomes were reported, preliminary meta-analyses were performed using standardized mean differences with random-effects models. The certainty of evidence was assessed using the GRADE approach. Seven studies (n = 7) involving 776 participants were included. Interventions consisted of counseling or educational programs delivered through face-to-face sessions, group activities, or digital resources. Overall, the interventions were associated with improvements in pregnancy-related knowledge, self-care behaviors, psychological outcomes, and maternal health practices and attitudes; however, the certainty of evidence was low to very low and a high risk of bias was identified across studies. Meta-analysis suggested a possible beneficial effect favoring the intervention for pregnancy-related health knowledge (SMD = 1.90; 95% CI: −0.02 to 3.83) and self-care behaviors (SMD = 2.39; 95% CI: 0.29 to 4.49), although substantial heterogeneity was observed. Counseling and educational interventions during pregnancy may contribute to improvements in pregnancy-related health knowledge and self-care among pregnant adolescents and young women; however, the current evidence is limited and of low certainty. Further well-designed studies conducted in diverse settings are needed to confirm these findings and strengthen the evidence base.