Background: People from culturally and linguistically diverse backgrounds experience significant disparities in pregnancy outcomes compared to the general population, including a higher risk of stillbirth. We aimed to identify programs or interventions for pregnant women from culturally and linguistically diverse backgrounds to prevent stillbirth, explore how these interventions have been tailored, and examine the impact and effectiveness of these programs for culturally and linguistically diverse pregnant women in high-income countries.
Methods: We included studies that report on the development and/or evaluation of a program or intervention to prevent stillbirth which has been specifically developed for pregnant women from culturally and linguistically diverse backgrounds living in high-income countries. We summarized the descriptive information of eligible studies using texts and tables and synthesized data qualitatively by type of intervention.
Results: Nine studies were included in the review: five randomised controlled trials, two mixed method studies; one interrupted time series study and one descriptive study. Studies were conducted in Australia, the UK, US and Denmark between 1986 and 2021, with multi-ethnic populations (n=6) or specific cultural and language groups (n=3) (e.g. Pakistani and Indian women; African American and Hispanic population groups). Approaches to cultural tailoring included the use of interpreters and translated materials, linking women to existing community resources and networks and community outreach delivered to women outside of hospital settings. Training of staff in cultural competence and multi-component, multiagency interventions addressing the wider social determinants of health and system-based approaches to facilitate access to language services were also identified. However, studies had poor statistical reporting, precluding conclusions about the efficacy of interventions on stillbirth outcomes.
Conclusion: There are currently few tailored interventions for pregnant women from culturally and linguistically diverse backgrounds to prevent stillbirth. Although some approaches to cultural tailoring were identified, more transparent reporting and rigourous evaluations are needed.