School of Medicine and Biomedical Sciences, University of Oxford, Oxford, UK.
National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
J Affect Disord. 2022 Jun 1;306:71-79. doi: 10.1016/j.jad.2022.03.032. Epub 2022 Mar 16.
Perinatal anxiety is associated with adverse outcomes for women and their infants. Women in low- and middle-income countries (LMIC) may be at higher risk of perinatal anxiety. We aimed to systematically review and synthesise the evidence on prevalence of perinatal anxiety in LMIC.
We searched MEDLINE, Embase, PscyhINFO, Global Health and Web of Science to identify studies assessing prevalence of perinatal anxiety in LMIC. Studies published since January 2016 were included. Screening and data extraction was conducted independently by two reviewers. Pooled prevalence estimates were calculated using random-effect meta-analyses and sources of heterogeneity explored through subgroup analyses and meta-regression.
We screened 9494 titles and abstracts, reviewed 700 full-texts and included 54 studies in the systematic review and meta-analysis. The pooled prevalence of self-reported anxiety symptoms was 29.2% (95%CI 24.5-34.2; I 98.7%; 36 studies; n = 28,755) antenatally and 24.4% (95%CI 16.2-33.7; I 98.5%; 15 studies; n = 6370) postnatally. The prevalence of clinically-diagnosed anxiety disorder was 8.1% (95%CI 4.4-12.8; I 88.1% 5 studies; n = 1659) antenatally and 16.0% (95% CI 13.5-18.9; n = 113) postnatally.
Our search was limited to studies published since January 2016 in order to update a previous review on this topic.
Perinatal anxiety represents a significant burden in LMIC, with one in four women experiencing symptoms during pregnancy or postpartum. Research remains lacking in a significant proportion of LMIC, particularly in the lowest income countries. Further research should guide application of screening tools in clinical settings to identify women with anxiety disorders in order to provide appropriate treatment.
围产期焦虑与妇女及其婴儿的不良结局有关。中低收入国家（LMIC）的妇女可能面临更高的围产期焦虑风险。我们旨在系统地回顾和综合中低收入国家围产期焦虑的证据。
我们检索了 MEDLINE、Embase、PscyhINFO、全球卫生和 Web of Science，以确定评估中低收入国家围产期焦虑患病率的研究。纳入了自 2016 年 1 月以来发表的研究。两名评审员独立进行筛选和数据提取。使用随机效应荟萃分析计算汇总患病率估计值，并通过亚组分析和荟萃回归探索异质性来源。
我们筛选了 9494 篇标题和摘要，审查了 700 篇全文，并将 54 项研究纳入系统评价和荟萃分析。自我报告的焦虑症状的汇总患病率为 29.2%（95%CI 24.5-34.2；I 98.7%；36 项研究；n=28755）在产前和 24.4%（95%CI 16.2-33.7；I 98.5%；15 项研究；n=6370）在产后。产前临床诊断的焦虑障碍患病率为 8.1%（95%CI 4.4-12.8；I 88.1%；5 项研究；n=1659）和 16.0%（95%CI 13.5-18.9；n=113）产后。
我们的搜索仅限于自 2016 年 1 月以来发表的研究，以便更新该主题的先前综述。
围产期焦虑在中低收入国家是一个重大负担，四分之一的妇女在怀孕或产后期间出现症状。在很大一部分中低收入国家，特别是在收入最低的国家，研究仍然缺乏。进一步的研究应该指导在临床环境中应用筛查工具，以识别患有焦虑症的妇女，以便提供适当的治疗。
