University of Michigan Medical School, 1301 Catherine St, Ann Arbor, MI, 48109, USA.
Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA.
BMC Public Health. 2024 Sep 6;24(1):2425. doi: 10.1186/s12889-024-19935-3.
Pregnancy-related anxiety significantly impacts maternal and fetal health in low- and middle-income countries (LMICs), including those within Sub-Saharan Africa (SSA). Most studies conducted to evaluate pregnancy-related anxiety in LMICs have utilized scales developed in high-income countries, despite significant variations in pregnancy-related anxiety due to socioeconomic and cultural contexts. This review surveyed existing literature in order to identify which scales have been used to measure pregnancy-related anxiety in SSA.
A systematic search was conducted in PubMed, Health and Psychosocial Instruments, and APA PsycNet for relevant studies published in the English language up to March 22, 2023. Eligible studies focused on anxiety in pregnant populations within SSA, using validated scales or tools. Screening followed PRIMSA guidelines, with blinded review at the abstract/title level and subsequent full-text review. Data was extracted and analyzed to identify trends and characteristics of the screening tools used.
From 271 articles, 37 met inclusion criteria, identifying 24 different tools used to measure anxiety in pregnant women in SSA. The most common tools were the Generalized Anxiety Disorder 7-item scale (seven uses), State-Trait Anxiety Inventory (five uses), and the Self-Reporting Questionnaire 20 (five uses). Seven tools were pregnancy-specific, with only two designed specifically for SSA: the Risk Factor Assessment (RFA), and the 4-Item Screening Tool. Studies were most frequently conducted in South Africa, followed by Tanzania, Ethiopia, Nigeria, and Ghana.
This scoping review illustrates that only two tools (the RFA and 4-item Screening Tool) were created to assess pregnancy-related anxiety specifically in SSA. This highlights the need for more culturally sensitive tools tailored to the specific contexts of pregnant populations in SSA.
在中低收入国家（LMICs），包括撒哈拉以南非洲（SSA），与妊娠相关的焦虑显著影响母婴健康。大多数在 LMICs 中评估与妊娠相关的焦虑的研究都使用了在高收入国家开发的量表，尽管由于社会经济和文化背景的差异，与妊娠相关的焦虑存在显著差异。本综述调查了现有文献，以确定哪些量表已被用于测量 SSA 中的与妊娠相关的焦虑。
在 PubMed、Health and Psychosocial Instruments 和 APA PsycNet 中进行了系统搜索，以查找截至 2023 年 3 月 22 日在英语中发表的有关 SSA 中妊娠人群焦虑的相关研究。合格的研究侧重于 SSA 中妊娠人群的焦虑，使用经过验证的量表或工具。筛选遵循 PRISMA 指南，在摘要/标题级别进行盲法审查，然后进行全文审查。提取和分析数据以确定用于筛查的工具的趋势和特征。
从 271 篇文章中，有 37 篇符合纳入标准，确定了 24 种不同的工具用于测量 SSA 中孕妇的焦虑。最常用的工具是广泛性焦虑障碍 7 项量表（7 次使用）、状态特质焦虑量表（5 次使用）和自我报告问卷 20（5 次使用）。有 7 种工具是专门针对妊娠的，只有 2 种是专门为 SSA 设计的：风险因素评估（RFA）和 4 项筛查工具。研究最常在南非进行，其次是坦桑尼亚、埃塞俄比亚、尼日利亚和加纳。
本范围综述表明，只有两种工具（RFA 和 4 项筛查工具）是专门为评估 SSA 中与妊娠相关的焦虑而创建的。这突出表明需要更多针对 SSA 中妊娠人群特定背景的更具文化敏感性的工具。
