Abstract
BackgroundAntenatal common mental disorders (CMDs) including anxiety, depressive, adjustment, and somatoform disorders are prevalent worldwide. There is emerging evidence that experiencing a natural disaster might increase the risk of antenatal CMDs. This study aimed to synthesise the evidence about the prevalence and determinants of clinically-significant symptoms of antenatal CMDs among women who had recently experienced an earthquake.MethodsThis systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search included both electronic and manual components. Five major databases were searched. A data extraction table was used to summarise study characteristics and findings. Two authors examined the quality of studies independently using a quality assessment tool. A narrative synthesis of the findings reported.ResultsIn total seven articles met inclusion criteria. Quality scores ranged from six to seven out of ten. All the studies were cross-sectional surveys and were conducted in high and middle-income countries. Sample sizes varied among studies. The prevalence of clinically-significant symptoms of antenatal CMD ranged from 4.6% (95% CI, 3.2; 6.5) experiencing ‘psychological stress’ in Japan to 40.8% (95% CI, 35.5; 46.4) ‘depression’ in China. While all studies were conducted in an earthquake context, only four examined some aspect of earthquake experiences as a risk factor for antenatal CMDs. In multivariable analyses, higher marital conflict, poor social support, multiparity, stresses of pregnancy and the personality characteristic of a negative coping style were identified as risks and a positive coping style as protective against antenatal CMDs.ConclusionsThis systematic review found that women who have recently experienced an earthquake are at heightened risk of antenatal mental health problems. It indicates that in addition to the establishment of services for safe birth which is recognised in post-disaster management strategies, pregnancy mental health should be a priority. The review also revealed that there is no evidence available from the world’s low-income nations where natural disasters might have more profound impacts because local infrastructure is more fragile and where it is already established that women experience a higher burden of antenatal CMDs.Trial registrationPROSPERO-CRD42017056501.
Highlights
Antenatal common mental disorders (CMDs) which include anxiety, depressive, adjustment, and somatoform disorders [1] are prevalent worldwide
We summarised the prevalence of clinically-significant symptoms of CMDs and extracted or derived confidence interval, odds ratio, relative risk, coefficients, and significance of determinants of CMDs
Data were contributed by 2209 women who had experienced an earthquake and 7381 women in comparison conditions who had not
Summary
Antenatal common mental disorders (CMDs) which include anxiety, depressive, adjustment, and somatoform disorders [1] are prevalent worldwide. In a systematic review conducted in 2004 which included 21 papers representing 13 high-income countries, Bennett et al [2] reported that about 10% of women experienced ‘depression’ ( most studies had ascertained outcomes with symptom checklists and not diagnostic interviews), during pregnancy. The latest systematic review of antenatal ‘depression’ published in 2016 which included 51 studies published from 1998 to 2015 and representing 20 lowand middle-income countries. This review reported significant heterogeneity and publication bias between studies [4] This could be possible explanations for the much higher prevalence in this review than those of the previous study. These reviews showed that the prevalence of antenatal CMDs is high worldwide. This study aimed to synthesise the evidence about the prevalence and determinants of clinically-significant symptoms of antenatal CMDs among women who had recently experienced an earthquake
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have