Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis

Çevik, Ayseren; Köroğlu, Cemile Onat; Karaçam, Zekiye; Sürücü, Şule Gökyıldız; Alan, Sultan

doi:10.1177/10547738221112748

Cited by 5 publications

(4 citation statements)

References 90 publications

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“…For the umbrella review, we identified 904 systematic reviews with or without meta-analyses. Of those, 781 reviews were excluded for several reasons such as not including a meta-analysis or wrong outcome ( Fig 1 ), retaining 123 eligible reviews with meta-analyses of primary studies published in 2021 and 2022 (initial search [ 9 , 10 , 25 – 80 ]; updated search [ 5 , 81 – 144 ]).…”

Section: Resultsmentioning

confidence: 99%

COVID-19 and common mental health symptoms in the early phase of the pandemic: An umbrella review of the evidence

et al. 2023

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Background There remains uncertainty about the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on mental health. This umbrella review provides a comprehensive overview of the association between the pandemic and common mental disorders. We qualitatively summarized evidence from reviews with meta-analyses of individual study-data in the general population, healthcare workers, and specific at-risk populations. Methods and findings A systematic search was carried out in 5 databases for peer-reviewed systematic reviews with meta-analyses of prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms during the pandemic published between December 31, 2019 until August 12, 2022. We identified 123 reviews of which 7 provided standardized mean differences (SMDs) either from longitudinal pre- to during pandemic study-data or from cross-sectional study-data compared to matched pre-pandemic data. Methodological quality rated with the Assessment of Multiple Systematic Reviews checklist scores (AMSTAR 2) instrument was generally low to moderate. Small but significant increases of depression, anxiety, and/or general mental health symptoms were reported in the general population, in people with preexisting physical health conditions, and in children (3 reviews; SMDs ranged from 0.11 to 0.28). Mental health and depression symptoms significantly increased during periods of social restrictions (1 review; SMDs of 0.41 and 0.83, respectively) but anxiety symptoms did not (SMD: 0.26). Increases of depression symptoms were generally larger and longer-lasting during the pandemic (3 reviews; SMDs depression ranged from 0.16 to 0.23) than those of anxiety (2 reviews: SMDs 0.12 and 0.18). Females showed a significantly larger increase in anxiety symptoms than males (1 review: SMD 0.15). In healthcare workers, people with preexisting mental disorders, any patient group, children and adolescents, and in students, no significant differences from pre- to during pandemic were found (2 reviews; SMD’s ranging from −0.16 to 0.48). In 116 reviews pooled cross-sectional prevalence rates of depression, anxiety, and PTSD symptoms ranged from 9% to 48% across populations. Although heterogeneity between studies was high and largely unexplained, assessment tools and cut-offs used, age, sex or gender, and COVID-19 exposure factors were found to be moderators in some reviews. The major limitations are the inability to quantify and explain the high heterogeneity across reviews included and the shortage of within-person data from multiple longitudinal studies. Conclusions A small but consistent deterioration of mental health and particularly depression during early pandemic and during social restrictions has been found in the general population and in people with chronic somatic disorders. Also, associations between mental health and the pandemic were stronger in females and younger age groups than in others. Explanatory individual-level, COVID-19 exposure, and time-course factors were scarce and showed inconsistencies across reviews. For policy and research, repeated assessments of mental health in population panels including vulnerable individuals are recommended to respond to current and future health crises.

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Section: Resultsmentioning

confidence: 99%

COVID-19 and common mental health symptoms in the early phase of the pandemic: An umbrella review of the evidence

et al. 2023

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“…Anxiety, depression, and stress symptoms are highly prevalent in pregnant women [ 6 , 33 ]. These psychological factors can alter maternal mental health, which can dramatically affect the child development [ 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Prenatal Yoga-Based Interventions May Improve Mental Health during Pregnancy: An Overview of Systematic Reviews with Meta-Analysis

Villar-Alises

Martínez-Miranda

Martínez-Calderón

2023

IJERPH

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An overview of systematic reviews with meta-analysis was developed to summarize evidence on the effectiveness of prenatal yoga-based interventions on pain, psychological symptoms, and quality of life during pregnancy. CINAHL (via EBSCOhost), Embase, PubMed, SPORTDiscus (via EBSCOhost), and the Cochrane Library were searched from inception to 15 December 2022. The intervention of interest was any prenatal yoga-based intervention. Pain, psychological symptoms, and quality of life were considered as outcome measures. The methodological quality of systematic reviews was judged using AMSTAR 2. The primary study overlap among systematic reviews was evaluated, building a citation matrix and calculating the corrected covered area (CCA). A total of ten systematic reviews, including fifteen meta-analyses of interest and comprising 32 distinct primary clinical trials, were included. Meta-analyses on pain and quality of life were not found. Most meta-analyses (93%) showed that prenatal yoga-based interventions are more effective than control interventions in reducing anxiety, depression, and stress symptoms. However, the overall methodological quality of systematic reviews was judged as critically low, and primary study overlap among systematic reviews was very high (CCA = 16%). Altogether, prenatal yoga-based interventions could improve the mental health of pregnant women, although due to the important methodological flaws that were detected, future systematic reviews should improve their methodological quality before drawing firm conclusions on this topic.

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“…Some studies suggested that perinatal women during the COVID‐19 pandemic were more likely to experience anxiety and depression symptoms than before. 39 , 62 Contrastingly, other results on pregnant women showed no difference in depression and anxiety levels before and during the COVID‐19 pandemic. 63 Nevertheless, considering differences in between studies methodology and procedure these results are not comparable.…”

Section: Discussionmentioning

confidence: 85%

“…Although it did not represent an aim of the current research, contrasting results emerged from SR&MA reviewed. Some studies suggested that perinatal women during the COVID‐19 pandemic were more likely to experience anxiety and depression symptoms than before 39,62 . Contrastingly, other results on pregnant women showed no difference in depression and anxiety levels before and during the COVID‐19 pandemic 63 .…”

Section: Discussionmentioning

confidence: 98%

Global prevalence of perinatal depression and anxiety during the COVID‐19 pandemic: An umbrella review and meta‐analytic synthesis

Caffieri,

Gómez‐Gómez,

Barquero‐Jimenez

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionThe prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID‐19 pandemic was assessed by several systematic reviews (SRs) and meta‐analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID‐19 pandemic.Material and methodsAn umbrella review of SRs and meta‐analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta‐analyses reporting the prevalence of perinatal anxiety and depression during the COVID‐19 pandemic were selected for eligibility. Primary studies extracted from eligible meta‐analyses were included in the quantitative synthesis. The research protocol was registered on PROSPERO (CRD42020173125).ResultsA total of 25 SRs (198 primary studies) and 12 meta‐analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n = 55; 95% CI: 25%–33%) and 26% (n = 54; 95% CI: 23%–30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n = 44; 95% CI: 26%–37%; n = 16; 95% CI: 24%–39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium‐high quality of the studies was observed. One SR assessed strength‐of‐evidence, reporting very low strength.ConclusionsDuring the COVID‐19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut‐offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID‐19 pandemic was the main factor that directly increased perinatal depression and anxiety during the past few years. Future studies should study other factors' impact.

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Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 90 publications

COVID-19 and common mental health symptoms in the early phase of the pandemic: An umbrella review of the evidence

COVID-19 and common mental health symptoms in the early phase of the pandemic: An umbrella review of the evidence

Prenatal Yoga-Based Interventions May Improve Mental Health during Pregnancy: An Overview of Systematic Reviews with Meta-Analysis

Global prevalence of perinatal depression and anxiety during the COVID‐19 pandemic: An umbrella review and meta‐analytic synthesis

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