Digital decision aids and prenatal outcomes: a systematic review and meta-analysis

Digitally delivered patient decision aids are becoming more prevalent to support prenatal decision-making. However, the effect of digital decision aids on prenatal outcomes is unclear. The objective of this systematic review and meta-analysis is to synthesize the currently available evidence on the effect of digital decision aids on prenatal outcomes, and quantitatively analyze the effect of interventions on prenatal outcomes across studies.

Studies that used digital decision aids (I) and measured prenatal care outcomes (O) for pregnant women (P) were eligible for inclusion. Ovid MEDLINE, CINAHL, Scopus, and Cochrane were searched from inception to November 2024. The protocol was registered on Open Science Framework.

3106 results were identified from databases. After deduplication, 2494 were screened. 11 studies were included in the review. Decision aids were found to improve knowledge and reduce decisional conflict. In a meta-analysis analyzing decisional conflict, interventions were favored (SMD -0.15; 95%CI -0.24, -0.06).

Digital decision aids can improve prenatal decisional quality, though we found less evidence for their effect on changing interventional decisions. Research is still needed on the most effective digital formats and strategies for implementation of decision aids in real-world environments to assess the benefits of digital decision aids for prenatal care.

The protocol was registered on Open Science Framework (osf.io/p2vb5).