{
  "abstract": "Objectives Peer support is being integrated into the new maternal mental health services in England to further the development of the recovery approach in relation to loss. Psychological support after miscarriage (pregnancy loss prior to viability) is often overlooked, despite significant psychological morbidity. This systematic review explored the effectiveness of peer support interventions to improve mental health outcomes after miscarriage.Design Systematic reviewData sources A comprehensive systematic search across nine databases (MEDLINE, CINAHL, APA PsycINFO, Web of Science (all databases), EMBASE, CENTRAL, LENS.org, British Nursing Index and Health Management Information Consortium) was conducted in June 2025. Grey literature was identified through website searching, contact with topic experts and a national call for evidence.Eligibility criteria Study designs with a quantitative evaluative component or mixed-methods studies reporting effectiveness were eligible if they involved women and/or partners who had experienced miscarriage and been offered a peer support intervention. Any peer support versus control (no treatment, wait list and usual care) or peer support versus another psychosocial intervention was eligible for inclusion. Studies that report any of the following broad groups of outcomes (whether validated measures or by self-report) were eligible for inclusion: (a) personal recovery, (b) mental health recovery, (c) health service use and (d) social outcomes.Data extraction and synthesis Two independent reviewers used standardised methods to search and screen for eligible studies.Results Of the 4342 titles screened, 100 potentially relevant full-text papers were retrieved and screened resulting in seven randomised controlled trials and two controlled trials identified across 10 papers. Of these, seven did not evaluate a peer-led intervention, one reported only on women who had experienced pregnancy loss later than 24 weeks gestation, and one reported a peer support intervention for those who experienced pregnancy loss at any age of gestation but did not disaggregate data for those who experienced miscarriage. Thus, no studies were eligible for inclusion. This indicates a significant gap in the current literature. The inconsistencies and limitations in existing research approaches are explored in detail.Conclusions This systematic review has identified an evidence gap as there is currently no robust evidence for the effectiveness of peer support interventions after miscarriage. Given the drive for the inclusion of peer support in new maternal mental health services, there is therefore a need for targeted intervention research to provide reliable evidence to determine effective peer support interventions for this population.PROSPERO registration number CRD42024518248",
  "authors": [
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Leanne Burton"
    },
    {
      "affiliations": [
        "The Miscarriage Association, Wakefield, UK"
      ],
      "name": "Juanita Charles"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Mary Gemma Cherry"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Rhiannon Corcoran"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Shaima Hassan"
    },
    {
      "affiliations": [
        "Liverpool Reviews and Implementation Group (LRiG), Department of Health Data Science, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Ruaraidh Hill"
    },
    {
      "affiliations": [
        "Independent Researcher (Public Advisor), Merseyside, UK"
      ],
      "name": "Sarah Little"
    },
    {
      "affiliations": [
        "Liverpool Reviews and Implementation Group (LRiG), Department of Health Data Science, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Michelle Maden"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Helen Mulholland"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Elizabeth Perkins"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Pauline Slade"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Selina Wallis"
    },
    {
      "affiliations": [
        "Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Paul Marshall"
    }
  ],
  "title": "Effectiveness of peer support interventions to improve mental health outcomes after miscarriage: a systematic review and call for high-quality evidence",
  "uid": "e21143c5-73b0-5c47-b469-749fbf6f808d"
}