The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis

Abstract

Background This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. Methods All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 – July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. Results This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. Discussion It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. Other The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.

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

“…is the only meta‐analysis that provided separated data for trimesters. It observed the highest prevalence of anxiety in the third trimester, confirming previous data 60 . Conversely, the first trimester appeared as the most at‐risk for symptoms of depression, 60 in contrast with previous studies that did not find differences in depression between gestational trimesters 7 .…”

“…Due to the paucity of information that could be retrieved from the included MAs, it was not possible to provide prevalence rates stratified for pregnancy trimesters. Delanarolle et al 60 is the only meta-analysis that provided separated data for trimesters. It observed the highest prevalence of anxiety in the third trimester, confirming previous data.…”

Social distancing and mental health among pregnant women during the coronavirus pandemic

“…The mental health of pregnant women may have been particularly affected by the COVID-19 pandemic [1] and symptoms of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) have increased among pregnant women during the pandemic [2]. The combination of the usual concerns of pregnancy and the population-wide stressors of the pandemic created particular hardship.…”

Relationship focused mother–infant groups: Preliminary evaluation of improvements in maternal mental health, parenting confidence, and parental reflective functioning

“…There is clear evidence that shows a link between maternal psychological distress and poor outcomes for the infant (Slomian et al., 2019; Teti et al., 2017) as well as mother–infant interactions or the attachment relationship (Barnes & Theule, 2019). The prevalence rates of women's perinatal distress have recently been reported at approximately one in four new mothers (Delanerolle et al., 2023), although this estimate depends on the age of the infant and methods of assessment (Matthey, 2010). From Australian population data, one in five mothers of children aged 2 years or less have received a diagnosis of depression (Australian Institute of Health & Welfare, 2012).…”