Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis

Objectives To systematically synthesise the evidence on prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries (LMICs).Design Systematic review and meta-analysis.Data sources MEDLINE, Embase, PsycINFO, Scopus, Web of Science, Global Health, Global Ind...

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Main Authors: Charles Opondo, Holly Jenkins, Fiona Alderdice, Gracia Fellmeth, Zoe Daskalopoulou
Format: Article
Language:English
Published: BMJ Publishing Group 2024-07-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/2/1/e000215.full
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author Charles Opondo
Holly Jenkins
Fiona Alderdice
Gracia Fellmeth
Zoe Daskalopoulou
author_facet Charles Opondo
Holly Jenkins
Fiona Alderdice
Gracia Fellmeth
Zoe Daskalopoulou
author_sort Charles Opondo
collection DOAJ
description Objectives To systematically synthesise the evidence on prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries (LMICs).Design Systematic review and meta-analysis.Data sources MEDLINE, Embase, PsycINFO, Scopus, Web of Science, Global Health, Global Index Medicus and the grey literature were searched with no language or date restrictions. The final search was carried out on 3 May 2022.Eligibility criteria Cross-sectional, cohort or case–control studies that assessed the prevalence of PTSD in pregnant or postpartum women in LMICs were included.Data extraction and synthesis Screening, data extraction and quality assessment were conducted independently by two reviewers. Pooled prevalence estimates were calculated with 95% CIs and prediction intervals (PI) using random-effects meta-analyses. Subgroup analyses and meta-regression were conducted to explore possible sources of statistical heterogeneity.Results 39 studies were included in the systematic review of which 38 were included in meta-analysis. The pooled prevalence of clinically diagnosed perinatal PTSD was 4.2% (95% CI 2.2% to 6.8%; 95% PI 0–18%; 15 studies). The pooled prevalence of self-reported perinatal PTSD symptoms was 11.0% (95% CI 7.6% to 15.0%; 95% PI 0–36%; 23 studies). There was no evidence of differences in prevalence according to perinatal stage (antenatal versus postnatal), geographical region, type of setting or study quality.Conclusions Findings of this review suggest 1 in 10 perinatal women experiences symptoms of PTSD and 1 in 20 experiences clinically diagnosed PTSD. Statistical heterogeneity between studies persisted in subgroup analyses and results should be interpreted with caution. More research from low-income countries is needed to improve understanding of the burden of perinatal PTSD in these settings.PROSPERO registration number CRD42022325072.
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spelling doaj-art-83487da6600148839ed90ffbaa167d4d2025-01-28T18:40:10ZengBMJ Publishing GroupBMJ Public Health2753-42942024-07-012110.1136/bmjph-2023-000215Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysisCharles Opondo0Holly Jenkins1Fiona Alderdice2Gracia Fellmeth3Zoe Daskalopoulou49 Nuffield Department of Population Health, University of Oxford, Oxford, UK1 Hertfordshire and West Essex Integrated Care Board, Welwyn Garden City, UK2 National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UKNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UKNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UKObjectives To systematically synthesise the evidence on prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries (LMICs).Design Systematic review and meta-analysis.Data sources MEDLINE, Embase, PsycINFO, Scopus, Web of Science, Global Health, Global Index Medicus and the grey literature were searched with no language or date restrictions. The final search was carried out on 3 May 2022.Eligibility criteria Cross-sectional, cohort or case–control studies that assessed the prevalence of PTSD in pregnant or postpartum women in LMICs were included.Data extraction and synthesis Screening, data extraction and quality assessment were conducted independently by two reviewers. Pooled prevalence estimates were calculated with 95% CIs and prediction intervals (PI) using random-effects meta-analyses. Subgroup analyses and meta-regression were conducted to explore possible sources of statistical heterogeneity.Results 39 studies were included in the systematic review of which 38 were included in meta-analysis. The pooled prevalence of clinically diagnosed perinatal PTSD was 4.2% (95% CI 2.2% to 6.8%; 95% PI 0–18%; 15 studies). The pooled prevalence of self-reported perinatal PTSD symptoms was 11.0% (95% CI 7.6% to 15.0%; 95% PI 0–36%; 23 studies). There was no evidence of differences in prevalence according to perinatal stage (antenatal versus postnatal), geographical region, type of setting or study quality.Conclusions Findings of this review suggest 1 in 10 perinatal women experiences symptoms of PTSD and 1 in 20 experiences clinically diagnosed PTSD. Statistical heterogeneity between studies persisted in subgroup analyses and results should be interpreted with caution. More research from low-income countries is needed to improve understanding of the burden of perinatal PTSD in these settings.PROSPERO registration number CRD42022325072.https://bmjpublichealth.bmj.com/content/2/1/e000215.full
spellingShingle Charles Opondo
Holly Jenkins
Fiona Alderdice
Gracia Fellmeth
Zoe Daskalopoulou
Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis
BMJ Public Health
title Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis
title_full Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis
title_fullStr Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis
title_full_unstemmed Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis
title_short Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis
title_sort prevalence of perinatal post traumatic stress disorder ptsd in low income and middle income countries a systematic review and meta analysis
url https://bmjpublichealth.bmj.com/content/2/1/e000215.full
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