Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK.
Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
BMC Pregnancy Childbirth. 2023 Jan 28;23(1):76. doi: 10.1186/s12884-022-05243-4.
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.
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.
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.
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.
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.
本系统评价旨在探讨 COVID-19、MERS 和 SARS 大流行对孕妇心理健康的影响的普遍性。
本研究纳入了 2000 年 12 月至 2021 年 7 月期间以英文发表的评估有/无妇科疾病的孕妇心理健康的所有 COVID-19、SARS 和 MERS 研究。根据研究问题制定了检索标准，并使用了 PubMed、Science Direct、Ovid PsycINFO 和 EMBASE 数据库进行检索。采用广泛的检索标准以确保纳入所有患有现有妇科疾病的孕妇。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa-Scale）评估所有纳入研究的偏倚风险。采用随机效应模型和最大似然估计法进行荟萃分析，并用 I 平方统计量评估研究间的异质性。计算了焦虑、抑郁、创伤后应激障碍、压力和睡眠障碍症状的合并患病率，并计算了 95%置信区间（CI）。
本系统评价共纳入了 217 项研究，共计纳入了 638889 名孕妇或刚分娩的妇女。没有研究报告 MERS 和 SARS 导致的心理健康影响。结果表明，在 COVID-19 大流行期间，孕妇或刚分娩的妇女表现出各种心理健康不良症状，包括抑郁（24.9%）、焦虑（32.8%）、压力（29.44%）、创伤后应激障碍（PTSD）（27.93%）和睡眠障碍（24.38%）。
值得注意的是，本综述纳入的研究使用了一系列不同的结局测量方法，因此无法直接比较研究结果。大多数研究报告了自我报告的症状测量值，而没有临床诊断，因此可以得出症状流行率的结论，而不是精神疾病的结论。在妊娠和分娩后管理心理健康可提高母亲的生活质量和幸福感，因此制定基于证据的方法作为大流行准备的一部分，将在困难时期改善心理健康。
本手稿中介绍的工作没有得到任何特定资助。为了探索几个关键目标，制定并发表了一份研究方案（PROSPERO：CRD42021235356）。
