High-risk pregnant women with physical or obstetric complications may develop depression and anxiety disorders that may worsen depending on the consequences of treatment and management during pregnancy. Therefore, their psychological well-being requires particular attention under these conditions. Consideration of specific and effective interventions for depression and anxiety would help improve the psychological outcomes of these women. This review aims to evaluate the effectiveness of cognitive behavioural therapy-based interventions for depression and anxiety in high-risk pregnant women.

This systematic review will follow the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness. The searches will be conducted in English in the following databases: MEDLINE, CINAHL, Web of Science, PsycINFO and Cochrane Central Register of Controlled Trials. Additionally, the Ichushi Web will be searched in English and Japanese. Sources of unpublished studies will be searched using ClinicalTrials.gov and the UMIN Clinical Trials Registry. Grey literature will be searched using DANS Data Stations. The JBI guidelines will be used for screening studies, study selection, critical appraisal, data extraction and integration. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to evaluate the certainty of the findings by two independent reviewers. If possible, statistical meta-analyses will be pooled. Additionally, the statistical heterogeneity will be assessed. Subgroup analysis will be performed according to participant and intervention characteristics. Funnel plots, Egger, Begg and Harbord tests will be used to detect publication bias, if necessary.

This systematic review does not require an ethics approval, as the data will be evaluated from previously published studies. The findings will be disseminated through publication in an international peer-reviewed journal and presented at research conferences.

CRD42024522468.

Adolescent pregnancy is a global issue. Early childbearing is strongly linked to poverty and negative health outcomes, including increased neonatal death risk. This study explores spatial patterns of adolescent pregnancies and neonatal deaths and their association with socioeconomic characteristics.

This population-based study used spatial analysis techniques to investigate the geographical distribution of adolescent pregnancies, socioeconomic characteristics and neonatal mortality rate (NMR).

The 645 municipalities of State of Sao Paulo, Brazil.

All live births to mothers residing in the State of Sao Paulo, Brazil, between 2004 and 2020.

The socioeconomic indicators used were: municipal human development index and per capita income (PCI). Spatial patterns were assessed for spatial autocorrelation (Moran’s I, LISA), and smoothed using local Bayesian estimation. Spearman’s correlation was used to ascertain the relationship between the percentage of live births to adolescent mothers and socioeconomic indexes. This calculation was also undertaken between different maternal age groups of NMR.

The study analysed over 10 million live births, with 14.3% attributed to adolescent mothers. Spatial analysis revealed significant clustering of adolescent pregnancies, strongly associated with lower socioeconomic indicators. NMR also exhibited spatial clustering, particularly after smoothing. Statistically significant differences were observed in PCI medians between high–high and low–low clusters for adolescent births. High and low incidence areas of NMR, both in all maternal ages and stratified by adolescent and non-adolescent mothers, demonstrated considerable overlap.

The results indicated the existence of clustering areas of adolescent pregnancy and neonatal deaths and suggested that the prevalence of births to adolescent mothers is not distributed equally and is higher in lower socioeconomic developed areas.