A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women

Abstract

Background

COVID-19 has started to spread within China since the end of December 2019. As a special population, the pregnant and delivery women maybe influenced both in physical and psychological aspects. The meta-analysis was conducted about mental health in pregnant and delivery women.

Methods

We searched both MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG and CSSCI in Chinese to find literature from December 2019 to 31 July 2020 related to COVID-19 and mental health in patient with pregnancy and delivery, among which results such as comments, letters, reviews and case reports were excluded. The prevalence of anxiety and depression in the population was synthesized and discussed.

Results

A total of 11,187 subjects were included in 15 studies. Random effect model is used to account for the data by Revman 5.2. The results showed that the prevalence of depression was 30% (95% CI: 0.23–0.37), the prevalence of anxiety was 34% (95% CI: 0.26–0.43) and prevalence of both anxiety and depression was 18% (95% CI: 0.09–0.29). The prevalence of anxiety (OR = 2.15, 95% CI: 1.39–3.31, Z = 3.47, p=.0005), depression (OR = 1.95, 95% CI: 1.07–3.56, Z = 2.19, p=.03) were higher than that of controls. Significant heterogeneity was detected across studies regarding these prevalence estimates. Subgroup analysis was taken according to assessment tools, and sensitivity analysis was done to explore the sources of heterogeneity.

Conclusions

The higher prevalence of depression, anxiety, both depression and anxiety in women with pregnancy and delivery during COVID-19 pandemic although the significant heterogeneity detected in studies. We must interpret the results with caution and also put attention to this result. As the epidemic is ongoing, it is vital to set up a comprehensive crisis prevention system.

Keywords:

• COVID-19
• anxiety
• depression
• meta-analysis
• pregnancy and delivery

Acknowledgements

The authors thank Mr Xing Baoping for giving us study idea and Mr Wang Zhiqiang for helping us in literature retrieval. We thank Ms Ren Xin for helping us in part of statistic. We thank Prof Fang Marong for helping in final revision of the article.

Consent to participate

All the participants agreed to use and publish their data.

Consent to publication

All authors agreed to publish.

Author contributions

Our authors have different contributions to this article. Dr SFL participated in collection of data and the writing of the article, SFL and Dr ZJF assessed the quality of researched papers. Mr ZJF complete most statistic analysis. All authors reviewed all researched paper. Mr MYC complete primary version of manuscript. Prof JWD participated in the design , statistical processing and the final revision of the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).