Pregnancy and birth complications associations with long-term adverse maternal mental health outcomes: a systematic review and meta-analysis protocol

Elizabeth O Bodunde; Daire Buckley; Eimear O'Neill; Gillian M Maher; Karen Matvienko-Sikar; Karen O'Connor; Fergus P McCarthy; Ali S Khashan

doi:10.12688/hrbopenres.13660.3

Pregnancy and birth complications associations with long-term adverse maternal mental health outcomes: a systematic review and meta-analysis protocol

HRB Open Res. 2023 Oct 24:6:3. doi: 10.12688/hrbopenres.13660.3. eCollection 2023.

Authors

Elizabeth O Bodunde^{1

2}, Daire Buckley², Eimear O'Neill³, Gillian M Maher^{1

2}, Karen Matvienko-Sikar¹, Karen O'Connor^{4

5}, Fergus P McCarthy^{2

6}, Ali S Khashan^{1

2}

Affiliations

¹ School of Public Health, University College Cork, Cork, Ireland.
² INFANT Research Centre, University College Cork, Cork, Ireland.
³ Perinatal Mental Health, AMHS and CAMHS, University College Cork, Cork, Ireland.
⁴ RISE, Early Intervention in Psychosis Team, South Lee Mental Health Services, Cork, Ireland.
⁵ Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland.
⁶ Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland.

Abstract

Background: Existing studies have established an association between pregnancy, birth complications, and mental health in the first few weeks postpartum. However, there is no clear understanding of whether pregnancy and birth complications increase the risk of adverse maternal mental outcomes in the longer term. Research on maternal adverse mental health outcomes following pregnancy and birth complications beyond 12 months postpartum is scarce, and findings are inconsistent.

Objective: This systematic review and meta-analysis will examine the available evidence on the association between pregnancy and birth complications and long-term adverse maternal mental health outcomes.

Methods and analysis: We will include cohort, cross-sectional, and case-control studies in which a diagnosis of pregnancy and/or birth complication (preeclampsia, pregnancy loss, caesarean section, preterm birth, perineal laceration, neonatal intensive care unit admission, major obstetric haemorrhage, and birth injury/trauma) was reported and maternal mental disorders (depression, anxiety disorders, bipolar disorders, psychosis, and schizophrenia) after 12 months postpartum were the outcomes. A systematic search of PubMed, Embase, CINAHL, PsycINFO, and Web of Science will be conducted following a detailed search strategy until August 2022. Three authors will independently review titles and abstracts of all eligible studies, extract data using pre-defined standardised data extraction and assess the quality of each study using the Newcastle-Ottawa Scale. We will use random-effects meta-analysis for each exposure and outcome variable to calculate overall pooled estimates using the generic inverse variance method. This systematic review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

Ethical consideration: The proposed systematic review and meta-analysis is based on published data; ethics approval is not required. The results will be presented at scientific meetings and publish in a peer-reviewed journal.

Prospero registration: CRD42022359017.

Keywords: Pregnancy; adverse mental health outcome; birth; complications; long-term.

Associated data

figshare/10.6084/m9.figshare.21572304

Grants and funding

HRB (SPHeRE-2018-1). The funders had no role in the study design, data collection, and analysis, decision to publish, and manuscript preparation.