Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: An umbrella review and meta-analytic synthesis.
COVID-19 pandemic
anxiety
depression
postpartum
pregnancy
prevalence
umbrella review
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
19 Dec 2023
19 Dec 2023
Historique:
revised:
08
11
2023
received:
27
06
2023
accepted:
09
11
2023
medline:
19
12
2023
pubmed:
19
12
2023
entrez:
19
12
2023
Statut:
aheadofprint
Résumé
The 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. An 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). A 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. During 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.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : European Research Council under the European Union's Horizon Europe
ID : Grant agreement ID: 101042139
Informations de copyright
© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
Références
Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014;28:25-35.
Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800-1819.
Glazer KB, Howell EA. A way forward in the maternal mortality crisis: addressing maternal health disparities and mental health. Arch Womens Ment Health. 2021;24(5):823-830.
Diguisto C, Saucedo M, Kallianidis A, et al. Maternal mortality in eight European countries with enhanced surveillance systems: descriptive population-based study. BMJ. 2022;379:e070621.
Paschetta E, Berrisford G, Coccia F, et al. Perinatal psychiatric disorders: an overview. Am J Obstet Gynecol. 2014;210(6):501-509.
Cantwell R. Mental disorder in pregnancy and the early postpartum. Anaesthesia. 2021;76:76-83.
Yin X, Sun N, Jiang N, et al. Prevalence and associated factors of antenatal depression: systematic reviews and meta-analyses. Clin Psychol Rev. 2021;83:101932.
Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86-92.
Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Front Psych. 2018;8:248.
Shorey S, Chee CYI, Ng ED, Chan YH, San Tam WW, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res. 2018;104:235-248.
Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017;210(5):315-323.
Zhang T, Luo ZC, Ji Y, et al. The impact of maternal depression, anxiety, and stress on early neurodevelopment in boys and girls. J Affect Disord. 2023;321:74-82.
Bick D, Cheyne H, Chang YS, Fisher J. Maternal postnatal health during the COVID-19 pandemic: vigilance is needed. Midwifery. 2020;88:102781.
Wong SF, Chow KM, Leung TN, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191(1):292-297.
Mullins E, Evans D, Viner RM, O'Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol. 2020;55(5):586-592.
Wastnedge EA, Reynolds RM, Van Boeckel SR, et al. Pregnancy and COVID-19. Physiol Rev. 2021;101(1):303-318.
Simbar M, Nazarpour S, Sheidaei A. Evaluation of pregnancy outcomes in mothers with COVID-19 infection: a systematic review and meta-analysis. J Obstet Gynaecol. 2023;43(1):2162867.
Mateus V, Cruz S, Costa R, et al. Rates of depressive and anxiety symptoms in the perinatal period during the COVID-19 pandemic: comparisons between countries and with pre-pandemic data. J Affect Disord. 2022;316:245-253.
Motrico E, Bina R, Domínguez-Salas S, et al. Impact of the Covid-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19): protocol for an international prospective cohort study. BMC Public Health. 2021;21(1):1-11.
Biondi-Zoccai G. Umbrella Reviews. Evidence Synthesis with Overviews of Reviews and Meta-Epidemiologic Studies. Springer International; 2016.
Pollock M, Fernandes R, Becker L, Pieper D, Hartling L. Chapter V: overviews of reviews. In: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, Welch V. Cochrane Handbook for Systematic Reviews of Interventions 6.3. Cochrane; 2022. https://training.cochrane.org/handbook/current/chapter-v
Gates M, Gates A, Pieper D, et al. Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement. BMJ. 2022;378:e070849.
Bougioukas KI, Bouras E, Apostolidou-Kiouti F, Kokkali S, Arvanitidou M, Haidich AB. Reporting guidelines on how to write a complete and transparent abstract for overviews of systematic reviews of health care interventions. J Clin Epidemiol. 2019;106:70-79.
Higgins JPT, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions Version 6.3. Cochrane; 2022. www.training.cochrane.org/handbook
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71.
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5:1-10.
Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Health. 2015;13:132-140.
Fernandez R, Sikhosana N, Green H, et al. Anxiety and depression among healthcare workers during the COVID-19 pandemic: a systematic umbrella review of the global evidence. BMJ Open. 2021;11(9):e054528.
Schultz TJ, Roupas P, Wiechula R, et al. Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews. JBI Database System Rev Implement Rep. 2016;14(8):257-308.
Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401-406.
Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the journal of clinical epidemiology. J Clin Epidemiol. 2011;64(4):380-382.
Stuck AE, Rubenstein LZ, Wieland D. Bias in meta-analysis detected by a simple, graphical test. Asymmetry detected in funnel plot was probably due to true heterogeneity. BMJ. 1998;316(7129):469-477.
Press S. Stata Statistical Software: Release 16. StataCorp LLC; 2019.
Low SR, Bono SA, Azmi Z. Prevalence and factors of postpartum depression during the COVID-19 pandemic: a review. Curr Psychol. 2023;1-18.
Ahmad M, Vismara L. The psychological impact of COVID-19 pandemic on women's mental health during pregnancy: a rapid evidence review. Int J Environ Res Public Health. 2021;18(13):7112.
Ansariniaki M, Abounoori M, Babakhanian M. A systematic review of anxiety during pregnancy in the period of the COVID-19 pandemic. Int J Pediatr. 2021;9(11):14756-14771.
Iyengar U, Jaiprakash B, Haitsuka H, Kim S. One year into the pandemic: a systematic review of perinatal mental health outcomes during COVID-19. Front Psych. 2021;12:674194.
Chmielewska B, Barratt I, Townsend R, et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob Health. 2021;9(6):e759-e772.
Sun F, Zhu J, Tao H, Ma Y, Jin W. A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women. J Psychosom Obstet Gynecol. 2021;42(2):91-99.
Thakur R, Vandana K. The psychological impact of COVID-19 among antenatal women: a systematic literature review. NeuroQuantology. 2022;20:391-398.
Demissie DB, Bitew ZW. Mental health effect of covid-19 pandemic among women who are pregnant and/or lactating: a systematic review and meta-analysis. SAGE Open Med. 2021;9:1-11.
He Z, Chiu WT, Wu H, Ming WK. PMH4 the psychological and behavioral responses to Covid-19 epidemic in pregnant women in China: a nationwide survey. Value Health Reg Issues. 2020;22:S62.
Berthelot N, Lemieux R, Garon-Bissonnette J, Drouin-Maziade C, Martel É, Maziade M. Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic. Acta Obstet Gynecol Scand. 2020;99(8):848-855.
Chrzan-Dętkoś M, Walczak-Kozłowska T, Lipowska M. The need for additional mental health support for women in the postpartum period in the times of epidemic crisis. BMC Pregnancy Childbirth. 2021;21:114.
Janevic T, Maru S, Nowlin S, et al. Pandemic birthing: childbirth satisfaction, perceived health care bias, and postpartum health during the COVID-19 pandemic. Matern Child Health J. 2021;25(6):860-869.
Silverman ME, Burgos L, Rodriguez ZI, et al. Postpartum mood among universally screened high and low socioeconomic status patients during COVID-19 social restrictions in New York City. Sci Rep. 2020;10:22380.
Lin W, Wu B, Chen B, et al. Sleep conditions associate with anxiety and depression symptoms among pregnant women during the epidemic of COVID-19 in Shenzhen. J Affect Disord. 2021;281:567-573.
Mappa I, Distefano FA, Rizzo G. Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospective observational study. J Perinat Med. 2020;48(5):545-550.
Ceulemans M, Foulon V, Ngo E, et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic-a multinational cross-sectional study. Acta Obstet Gynecol Scand. 2021;100(7):1219-1229.
Fallon V, Davies SM, Silverio SA, Jackson L, de Pascalis L, Harrold JA. Psychosocial experiences of postnatal women during the COVID-19 pandemic: a UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety. J Psychiatr Res. 2021;136:157-166.
Mesquita A, Costa R, Bina R, et al. A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health. Sci Rep. 2023;13(1):2805.
International Monetary Fund. World economic outlook update. 2021. Accessed April 25, 2023. https://www.imf.org/en/Home
Mitchell RA, Gordon H, Lindquist A, et al. Prevalence of perinatal depression in low- and middle-income countries: a systematic review and meta-analysis. JAMA Psychiatry. 2023;80(5):425-431.
Endomba FT, Ndoadoumgue AL, Mbanga CM, et al. Perinatal depressive disorder prevalence in Africa: a systematic review and Bayesian analysis. Gen Hosp Psychiatry. 2021;69:55-60.
Murray L, Dunne MP, Van Vo T, Anh PNT, Khawaja NG, Cao TN. Postnatal depressive symptoms amongst women in Central Vietnam: a cross-sectional study investigating prevalence and associations with social, cultural, and infant factors. BMC Pregnancy Childbirth. 2015;15:1-12.
Insan N, Slack E, Heslehurst N, Rankin J. Antenatal depression and anxiety and early pregnancy BMI among White British and south Asian women: retrospective analysis of data from the born in Bradford cohort. BMC Pregnancy Childbirth. 2020;20:1-502.
Shorey SY, Ng ED, Chee CY. Anxiety and depressive symptoms of women in the perinatal period during the COVID-19 pandemic: a systematic review and meta-analysis. Scand J Public Health. 2021;49(7):730-740.
Sinesi A, Maxwell M, O'Carroll R, Cheyne H. Anxiety scales used in pregnancy: systematic review. BJPsych Open. 2019;5(1):e5.
Belbasis L, Brooker RD, Zavalis E, Pezzullo AM, Axfors C, Ioannidis JP. Mapping and systematic appraisal of umbrella reviews in epidemiological research: a protocol for a meta-epidemiological study. Syst Rev. 2023;12(1):123.
Delanerolle G, McCauley M, Hirsch M, et al. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2023;23(1):1-40.
Gao S, Su S, Zhang E, et al. Psychological health status in postpartum women during COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord. 2022;319:99-111.
Cevik A, Onat Koroglu C, Karacam Z, Gokyildiz Surucu S, Alan S. Effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression during pregnancy: a systematic review and meta-analysis. Clin Nurs Res. 2022;31(8):1405-1421.
Hessami K, Romanelli C, Chiurazzi M, Cozzolino M. COVID-19 pandemic and maternal mental health: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2022;35(20):4014-4021.
Motrico E, Domínguez Salas S, Rodríguez Domínguez C, Gómez- Gómez I, Rodríguez Muñoz MDLF, Gomez BD. The impact of the COVID-19 pandemic on perinatal depression and anxiety: a large cross-sectional study in Spain. Psicothema. 2022;34(2):200-208.
Luo Y, Zhang K, Huang M, Qiu C. Risk factors for depression and anxiety in pregnant women during the COVID-19 pandemic: evidence from meta-analysis. PloS One. 2022;17(3):e0265021.
Corbani IE, Rucci P, Iapichino E, et al. Comparing the prevalence and the risk profile for antenatal depressive symptoms across cultures. Int J Soc Psychiatry. 2017;63(7):622-631.
Borges Migliavaca C, Stein C, Colpani V, et al. How are systematic reviews of prevalence conducted? A methodological study. BMC Med Res Methodol. 2020;20:96.
Inter-Agency Working Group on Reproductive Health in crises. Collaborating for maternal mental wellbeing in crises. Technical Brief on Perinatal Mental Health in Humanitarian Settings. 2023. https://cdn.iawg.rygn.io/media/Technical-Brief_Perinatal-Mental-Health_FINAL.pdf?mtime=20230503013148&focal=none
Motrico E, Bina R, Kassianos AP, et al. Effectiveness of interventions to prevent perinatal depression: an umbrella review of systematic reviews and meta-analysis. Gen Hosp Psychiatry. 2023;82:47-61.
Motrico E, Moreno-Peral P, Uriko K, et al. Clinical practice guidelines with recommendations for peripartum depression: a European systematic review. Acta Psychiatr Scand. 2022;146(4):325-339.
Milgrom J, Gemmill AW. Screening for perinatal depression. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):13-23.
Martín-Gómez C, Moreno-Peral P, Bellón JA, et al. Effectiveness of psychological interventions in preventing postpartum depression in non-depressed women: a systematic review and meta-analysis of randomized controlled trials. Psychol Med. 2022;1-13:1001-1013.
Sun GQ, Wang Q, Wang SS, Cheng Y. Risk assessment of paternal depression in relation to partner delivery during COVID-19 pandemic in Wuhan, China. BMC Psychiatry. 2021;21(1):327.
Yazdanpanahi Z, Vizheh M, Azizi M, Hajifoghaha M. Paternal postnatal depression during COVID-19 pandemic: the role of health care providers. J Prim Care Community Health. 2022;13:1-6.
Solomou I, Constantinidou F. Prevalence and predictors of anxiety and depression symptoms during the COVID-19 pandemic and compliance with precautionary measures: age and sex matter. Int J Environ Res Public Health. 2020;17:4924.