Effects of e-Health interventions on psychological outcomes among high-risk pregnant women: a systematic review and meta-analysis

High-risk pregnant women face not only physical health issues but also substantial psychological challenges. With the growing interest in innovative strategies, e-Health interventions have gained recognition as a supportive approach for high-risk pregnant women. This systematic review and meta-analysis examined the effects of e-Health interventions on psychological outcomes in high-risk pregnant women. Interventional studies were identified through searches of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Central, and Scopus databases. A total of 15,996 articles were retrieved, and 42 interventional studies published between 2007 and 2024 were included in this systematic review and meta-analysis. Among 42 studies, 24 (57.2%) were published after 2020, and 32 (76.2%) were randomised controlled trials. The e-Health interventions focused on psychological support (47.6%), physical health management (42.9%), and parenting role education (9.5%). The meta-analysis indicated that e-Health interventions were associated with reductions in anxiety ( p = 0.017), depression ( p = 0.048), and stress ( p = 0.006) among high-risk pregnant women. The heterogeneity was high for the overall anxiety and depression analyses (I 2 > 80%), and these pooled estimates should be interpreted with caution. Given their accessibility, e-Health interventions may offer potential benefits for the psychological support of high-risk pregnant women; however, these findings should be interpreted cautiously owing to the high heterogeneity in the anxiety and depression estimates. Further research is required to confirm these effects and to evaluate their optimal design, long-term effects, and cost-effectiveness.