The Effectiveness of the Models and Guidelines on Detecting High-Risk Pregnancies: A Systematic Review

Background: The models or guidelines that make it possible for pregnant mothers to diagnose high-risk pregnancy signs and symptoms are not clearly stated. This systematic review was conducted to answer the question: what models/guidelines have contributed to women’s knowledge/performance regarding the detection of high-risk pregnancy?   Method: This systematic review uses the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement. The electronic databases used are PubMed, Cochrane, ProQuest, and Google Scholar in the time frame of 2010 to 2021. Main inclusion criteria were English interventional educational studies on high risk pregnant women in antenatal period using models or guidelines with more than 20 subjects. Review articles, editorials, comments, not full texts, case reports, and meta-analytical or systematic review articles were excluded. National Institute of Health (NIH) study quality assessment tool was used to assess the quality rating of the articles. The risk of bias was assessed by two authors independently using the Cochrane Collaboration revised tool. The studies were analyzed qualitatively by collecting the main findings, the design and the applied interventions. Results: A total of 1,173 articles were obtained from the four databases used. After eliminating duplicates, thesis/dissertation, proceedings, book chapters, those with no inclusion criteria, no discussing the high risk pregnancy, and low quality based on the NIH for interventional studies, the remaining five articles were entered into review process. Based on articles that met the inclusion criteria, it was found that the models used included the Health Belief Model, Bandura's self-efficacy theory, the World Food Program flip-chart, The Dietary Guidelines for Americans, and the Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women, with educational class and counseling approaches for women with high risk pregnancies.   Conclusion: This systematic review shows a generally positive effect of various models and guidelines for educating high risk pregnancy detection by pregnant women. Approaches to the application of the models include educational classes and counseling for these women. These models and guidelines have significant effect on the ability of pregnant women to recognize the symptoms of a high-risk pregnancy.