Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords "COVID-19", "pregnant women", and "depression". The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women; 2) description of depression; and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were "distress from COVID-19-related experiences", "reduced/low income", "unemployment", "anxiety", "history of mental illness", "lack of social support", and "reduced/no exercise". The protective factors "greater/increased social support", "higher education level", "higher resilience", and "healthy lifestyle behaviors" were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.

Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society using the keywords "COVID-19", "Pregnant Women" and "Depression". The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women; 2) description of depression; 3) description of COVID-19. Results: Of the 213 articles that were extracted, 104 were excluded owing to duplication and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 49 were excluded by title, abstract, and full-text screening. Among the 46 articles that met the inclusion criteria, 13 articles (28.3%) were from China, 8 (17.4%) were from Turkey, 4 (8.7%) were from the United States, and 3 (6.5%) were from Japan. The most common scales used to measure depression were the Edinburgh Postnatal Depression Scale (EPDS) used in 18 articles (39.1%), followed by the Patient Health Questionnaire (PHQ-9) used in 11 articles (23.9%). Furthermore, 46 sources reported a suspected depression rate of 30.0% (20,338/67,860 pregnant women). The rate of depression was 15.1% -33.5% using EPDS ≥ 9 in three articles and 12.0% -43.2% using EPDS ≥ 13 in nine articles. The five articles using PHQ-9 ≥ 5 reported 25.8% -48.7%, and seven articles reported 5.3% -59.2% using PHQ-9 ≥ 10. Conclusion: Depression was a concern for one out of every three to four pregnant women during the COVID-19 pandemic. This suggests that depression among pregnant women during COVID-19 might have worsened, highlighting the need for mental health support for them.