Anxiety of pregnant women in time of catastrophic events, including COVID-19 pandemic: a systematic review and meta-analysis

Abstract

Purpose

In March 2020, daily life was disrupted by the new virus SARS-CoV-2, which causes COVID-19. Pandemic-related prenatal anxiety could lead to depression, a risk factor for adverse pregnancy outcomes and abnormal neonatal development. This study aimed to investigate the impact of anxiety on the mental health of pregnant women exposed to catastrophic events as compared to those without such exposure.

Materials and methods

PubMed/MEDLINE, Web of Science, Cochrane Library, Scopus, and EMBASE were searched for relevant studies. This study compared the prevalence of anxiety among pregnant women during a catastrophic event.

Results

Fifteen full texts were assessed for inclusion, with 3 included, 10 excluded for not meeting criteria, and 2 excluded for other reasons. The included studies were published before the current COVID-19 pandemic but included the SARS 2003 outbreak. During the current COVID-19 pandemic, 10 further studies were conducted, but they failed to meet the inclusion criteria. A meta-analysis of two studies using STAI revealed that women exposed to a catastrophic event had a higher mean STAI score of 1.82 points (95% CI: 0.47–3.18 points).

Conclusion

Women with complications during pregnancy should be assessed for anxiety independently from catastrophic events. During financial crises, environmental or other disasters, special attention should be given to women with low risk, normal pregnancies.

Keywords:

• Maternal perinatal anxiety
• pregnancy
• catastrophic event
• natural disasters
• COVID-19
• distress
• perinatology

Acknowledgment

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author contributions

SF: data collection, interpretation of the results, writing the manuscript, critically reviewed, and contributed to the final version of the manuscript.

JM: data collection, interpretation of the results, writing the manuscript, critically reviewed, and contributed to the final version of the manuscript.

AK: conceived the original idea, data collection, interpretation of the results, writing the manuscript, critically reviewed, and contributed to the final version of the manuscript.

DS: interpretation of the results, critically reviewed, and contributed to the final version of the manuscript, acquisition, and organization during the review process.

SK: interpretation of the results, writing the manuscript, critically reviewed, and contributed to the final version of the manuscript.

EMS: writing the manuscript, critically reviewed, and contributed to the final version of the manuscript.

MR: writing the manuscript, critically reviewed, and contributed to the final version of the manuscript.

All of the coauthors approved the final version of the article.

Disclosure statement

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