Abstract
BackgroundPregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy.MethodsThe PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle–Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I2 statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis.ResultFrom the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety.ConclusionLow social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.
Highlights
Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness
Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women
It is supplemented by hormonal changes and can represent a time of increased risk for the occurrence of mental illness like depression, anxiety and self-harm
Summary
Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy. The common mental health problems women experiencing during pregnancy are anxiety [6], depression [7] and self-harm [8]. Individual studies have reported that the prevalence of antenatal anxiety range between 14 and 59% [10–13], while, a meta-analysis conducted on estimating the global prevalence of antenatal anxiety found that pooled prevalence of antenatal anxiety symptoms across all trimesters was 34.4% in low to middle-income countries and 19.4% in high-income countries [14]. An umbrella review conducted on examining the global prevalence of antenatal depression reported 15–65%, and 17% pooled prevalence of antenatal depression in low to middle-income countries and high-income countries respectively based on ten identified systematic reviews [17]
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