The effect of COVID-19 lockdowns on women's perinatal mental health: a systematic review.
Stephanie Wall, Maria Dempsey
PMID 35798661WHAT IT FOUND
Depression symptoms reached clinical levels in 9.9% to 49% and anxiety in 11% to 61% across studies of perinatal women during lockdown.
Friend support helped; family or partner support did not buffer.
Key findings
01In studies that screened for depression and anxiety, clinically significant depression ranged from 9.9% to 49% and anxiety from 11% to 61%; PTSD symptoms were reported by 10.2% of participants in one study, stress symptoms by 40% in one study, and loneliness and social isolation by 62% in one study.
02Lower perceived social support was linked with more anxiety, depression, repetitive negative thinking and loneliness. Friend support moderated the negative effects of repetitive negative thinking on anxiety and depression, but family or partner support did not.
03Almost 60% of women did not receive antenatal care after lockdown, compared with 4% before, and inability to afford food or income below £30,000 predicted poorer maternal mental health.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All included studies were cross-sectional, so they cannot show that lockdown caused the reported mental health symptoms. The studies used different measures, samples and lockdown rules, and the data were too heterogeneous for meta-analysis. Only English peer-reviewed quantitative studies were included, so publication bias is possible. Quality was mostly fair, with only three studies rated good, and no studies were excluded on quality grounds. Two studies did not use a formal assessment tool, and many outcomes relied on self-report rather than diagnostic screening. Definitions of previous mental health diagnosis varied, and some studies did not measure participants' anxiety before lockdown. Eleven studies did not provide a sample size justification.
The easy way to misread this
Do not read these percentages as proof that lockdown caused perinatal mental illness or as a pooled estimate for all women. All included studies were cross-sectional, used different measures and settings, and could not be combined in a meta-analysis.