Effect of COVID-19 on delivery plans and postnatal depression scores of pregnant women

Hui, P. W.; Ma, Grace; Seto, Mimi Tin Yan; Cheung, KW

doi:10.12809/hkmj208774

Cited by 43 publications

(63 citation statements)

References 8 publications

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“…On the basis of 11 studies, 14 , 15 , 18 , 21 , 26 , 30 , 31 , 32 , 33 , 38 , 46 there was no significant change in the rate of spontaneous vaginal delivery (OR 0·98 [95% CI 0·93–1·02]; I 2 =25%; appendix p 51 ) during versus before the pandemic. 17 studies, 6 , 14 , 15 , 18 , 19 , 21 , 25 , 26 , 30 , 31 , 32 , 33 , 38 , 42 , 45 , 46 , 49 including 48 550 pregnancies during and 67 442 before the pandemic, showed no significant change in caesarean section rate (1·03 [0·99–1·07]; I 2 =46%; table 3 , appendix p 52 ), with consistent findings when subdivided into HICs and LMICs. Additionally, on the basis of seven studies, 14 , 18 , 19 , 21 , 30 , 31 , 32 rates of instrumental delivery did not differ during versus before the pandemic (1·06 [0·97–1·15]; I 2 =0%; table 3 , appendix p 53 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of 3592 abstracts screened, 192 were relevant for full-text review and 40 met the inclusion criteria for systematic review ( figure 1 ). 4 , 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 A list of excluded studies with reasons for exclusion is provided in the appendix (p 6) . Reporting on resource use or service reconfiguration outcomes is summarised in the appendix (p 27) .…”

Section: Resultsmentioning

confidence: 99%

“…Of the 40 included studies, 31 for which comparable outcomes were also reported in at least one other study were included in the meta-analysis. 4 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 37 , 38 , 40 , 42 , 45 , 46 , 47 , 48 , 49 Table 1 shows the characteristics of the 40 included studies, all of which used a historical cohort design. 17 countries were represented, with substantial variation in pandemic mitigation measures among countries.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies 16 , 17 , 20 , 28 , 30 , 31 , 32 , 35 , 47 had a comparison group of annually matched periods from several preceding years ( table 1 ). 18 studies 4 , 5 , 13 , 14 , 18 , 21 , 22 , 25 , 26 , 27 , 29 , 36 , 37 , 41 , 43 , 44 , 46 , 48 had a comparison group from immediately before the lockdown period in the respective country. Exposed sample sizes varied from nine to 56 720 pregnancies ( table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“… 15 , 18 , 22 , 29 , 34 , 36 , 39 , 41 , 42 , 43 , 44 Assessment tools included the Generalised Anxiety and Depression Scale, EPDS, Generalised Anxiety Disorder 7 questionnaire, Inventory of Depression and Anxiety Symptoms (Expanded Form), Symptom Checklist 90 Revised, and Patient Health Questionnaire 9. Four studies 18 , 36 , 41 , 42 gave mean EPDS scores (on a scale of 0–30). One study violated the normality assumption and was excluded from quantitative synthesis.…”

Section: Resultsmentioning

confidence: 99%

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Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

Chmielewska

Barratt

Townsend

et al. 2021

The Lancet Global Health

847

820

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Background The COVID-19 pandemic has had a profound impact on health-care systems and potentially on pregnancy outcomes, but no systematic synthesis of evidence of this effect has been undertaken. We aimed to assess the collective evidence on the effects on maternal, fetal, and neonatal outcomes of the pandemic. Methods We did a systematic review and meta-analysis of studies on the effects of the pandemic on maternal, fetal, and neonatal outcomes. We searched MEDLINE and Embase in accordance with PRISMA guidelines, from Jan 1, 2020, to Jan 8, 2021, for case-control studies, cohort studies, and brief reports comparing maternal and perinatal mortality, maternal morbidity, pregnancy complications, and intrapartum and neonatal outcomes before and during the pandemic. We also planned to record any additional maternal and offspring outcomes identified. Studies of solely SARS-CoV-2-infected pregnant individuals, as well as case reports, studies without comparison groups, narrative or systematic literature reviews, preprints, and studies reporting on overlapping populations were excluded. Quantitative meta-analysis was done for an outcome when more than one study presented relevant data. Random-effects estimate of the pooled odds ratio (OR) of each outcome were generated with use of the Mantel-Haenszel method. This review was registered with PROSPERO (CRD42020211753). Findings The search identified 3592 citations, of which 40 studies were included. We identified significant increases in stillbirth (pooled OR 1·28 [95% CI 1·07–1·54]; I 2 =63%; 12 studies, 168 295 pregnancies during and 198 993 before the pandemic) and maternal death (1·37 [1·22–1·53; I 2 =0%, two studies [both from low-income and middle-income countries], 1 237 018 and 2 224 859 pregnancies) during versus before the pandemic. Preterm births before 37 weeks' gestation were not significantly changed overall (0·94 [0·87–1·02]; I 2 =75%; 15 studies, 170 640 and 656 423 pregnancies) but were decreased in high-income countries (0·91 [0·84–0·99]; I 2 =63%; 12 studies, 159 987 and 635 118 pregnancies), where spontaneous preterm birth was also decreased (0·81 [0·67–0·97]; two studies, 4204 and 6818 pregnancies). Mean Edinburgh Postnatal Depression Scale scores were higher, indicating poorer mental health, during versus before the pandemic (pooled mean difference 0·42 [95% CI 0·02–0·81; three studies, 2330 and 6517 pregnancies). Surgically managed ectopic pregnancies were increased during the pandemic (OR 5·81 [2·16–15·6]; I 2 =26%; three studies, 37 and 272 pregnancies). No overall significant effects were identified for other outcomes included in the quantitative analysis: maternal gestational diabetes; hypertensive disorders of pregnancy; preterm birth before 34 weeks', 32 weeks',...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

Chmielewska

Barratt

Townsend

et al. 2021

The Lancet Global Health

847

820

View full text Add to dashboard Cite

show abstract

Prevalence of postpartum depression in women amid the COVID‐19 pandemic: A systematic review and meta‐analysis

Safi-Keykaleh

Aliakbari

Safarpour

et al. 2022

Intl J Gynecology & Obste

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COVID‐19 outbreaks appear to be related to exacerbation of psychological problems such as depression and anxiety in high‐risk population such as pregnant women and the postpartum period due to stress and life‐threatening illnesses. The aim of this study was to evaluate the prevalence of postpartum depression (PPD) during COVID‐19. This study protocol is registered in PROSPERO with CRD42021278425 code. Data sources including Google Scholar, ISC, Magiran, Scopus, PubMed, Embase, and Web of Science and reference list of included articles were used to identify related studies. Observational studies that reported the prevalence of PPD in both Persian and English during COVID‐19 between January 20, 2020 and August 31, 2021 were included. Data were collected and analyzed with a random effects model for meta‐analysis. In this study, 671 initial articles were identified and after removing duplicates, 454 studies were screened and finally 24 studies entered the meta‐analysis stage. According to this study results PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥9, EPDS ≥10, EPDS ≥11, EPDS ≥12, EPDS ≥13, Postpartum Depression Screening Scale‐Short Form (PDSS‐SF) ≥17 and total prevalence was reported 12% (95% confidence interval [CI] = 0.07–17, I2 = 97%), 27% (95% CI = 15–39, I2 = 99%), 44% (95% CI = 40–49, I2 = 0.0%), 27% (95% CI = 0.06–49, I2 = 97.4%), 28% (95% CI = 18–39, I2 = 98.5%), 37% (95% CI = 32–42), 28% (95% CI = 23–33, I2 = 98.5%). The findings of this study showed that the prevalence of PPD in women is relatively high during COVID‐19. Therefore, considering the psychological consequences of the COVID‐19 pandemic and the importance of pregnancy and the postpartum period in terms of the emergence of mental disorders, especially depression, it seems necessary to perform interventions and physical and psychological support.

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Changes to women’s childbirth plans during the COVID-19 pandemic and posttraumatic stress symptoms: a cross-national study

Mesquita,

Costa,

Dikmen-Yildiz

et al. 2023

Arch Womens Ment Health

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A considerable number of women giving birth during COVID-19 pandemic reported being concerned about changes to their childbirth plans and experiences due to imposed restrictions. Research prior to the pandemic suggests that women may be more at risk of post-traumatic stress symptoms (PTSS) due to unmet expectations of their childbirth plans. Therefore, this study aimed to examine if the mismatch between women’s planned birth and actual birth experiences during COVID-19 was associated with women’s postpartum PTSS. Women in the postpartum period (up to 6 months after birth) across 11 countries reported on childbirth experiences, mental health, COVID-19-related factors, and PTSS (PTSD checklist DSM-5 version) using self-report questionnaires (ClinicalTrials.gov: NCT04595123). More than half (64%) of the 3532 postpartum women included in the analysis reported changes to their childbirth plans. All changes were significantly associated with PTSS scores. Participants with one and two changes to their childbirth plans had a 12% and 38% increase, respectively, in PTSS scores compared to those with no changes (Exp(β) = 1.12; 95% CI [1.06–1.19]; p < 0.001 and Exp(β) = 1.38; 95% CI [1.29–1.48]; p < 0.001). In addition, the effect of having one change in the childbirth plan on PTSS scores was stronger in primigravida than in multigravida (Exp(β) = 0.86; 95% CI [0.77–0.97]; p = 0.014). Changes to women’s childbirth plans during the COVID-19 pandemic were common and associated with women’s postpartum PTSS score. Developing health policies that protect women from the negative consequences of unexpected or unintended birth experiences is important for perinatal mental health.

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Effect of COVID-19 on delivery plans and postnatal depression scores of pregnant women

Cited by 43 publications

References 8 publications

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

Prevalence of postpartum depression in women amid the COVID‐19 pandemic: A systematic review and meta‐analysis

Changes to women’s childbirth plans during the COVID-19 pandemic and posttraumatic stress symptoms: a cross-national study

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