Pregnancy and birth complications and long-term maternal mental health outcomes: A systematic review and meta-analysis

IF 4.3 1区医学 Q1 OBSTETRICS & GYNECOLOGY Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-06-18 DOI:10.1111/1471-0528.17889

Elizabeth O. Bodunde, Daire Buckley, Eimear O'Neill, Sukainah Al Khalaf, Gillian M. Maher, Karen O'Connor, Fergus P. McCarthy, Karolina Kublickiene, Karen Matvienko-Sikar, Ali S. Khashan

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Abstract

Background

Few studies have examined the associations between pregnancy and birth complications and long-term (>12 months) maternal mental health outcomes.

Objectives

To review the published literature on pregnancy and birth complications and long-term maternal mental health outcomes.

Search strategy

Systematic search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase), PsycInfo®, PubMed® and Web of Science from inception until August 2022.

Selection criteria

Three reviewers independently reviewed titles, abstracts and full texts.

Data collection and analysis

Two reviewers independently extracted data and appraised study quality. Random-effects meta-analyses were used to calculate pooled estimates. The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were followed. The protocol was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022359017).

Main results

Of the 16 310 articles identified, 33 studies were included (3 973 631 participants). Termination of pregnancy was associated with depression (pooled adjusted odds ratio, aOR 1.49, 95% CI 1.20–1.83) and anxiety disorder (pooled aOR 1.43, 95% CI 1.20–1.71). Miscarriage was associated with depression (pooled aOR 1.97, 95% CI 1.38–2.82) and anxiety disorder (pooled aOR 1.24, 95% CI 1.11–1.39). Sensitivity analyses excluding early pregnancy loss and termination reported similar results. Preterm birth was associated with depression (pooled aOR 1.37, 95% CI 1.32–1.42), anxiety disorder (pooled aOR 0.97, 95% CI 0.41–2.27) and post-traumatic stress disorder (PTSD) (pooled aOR 1.75, 95% CI 0.52–5.89). Caesarean section was not significantly associated with PTSD (pooled aOR 2.51, 95% CI 0.75–8.37). There were few studies on other mental disorders and therefore it was not possible to perform meta-analyses.

Conclusions

Exposure to complications during pregnancy and birth increases the odds of long-term depression, anxiety disorder and PTSD.

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妊娠和分娩并发症与孕产妇长期心理健康结果：系统回顾与荟萃分析

很少有研究探讨妊娠和分娩并发症与长期（12 个月）孕产妇心理健康结果之间的关联。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.

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