Background Perinatal anxiety is associated with adverse outcomes for women and their infants. Women in low- and middle-income countries (LMIC) may be at higher risk of perinatal anxiety disorders.
Aims We aim to systematically review the evidence on prevalence of perinatal anxiety and calculate pooled prevalence estimates of antenatal and postnatal anxiety among women living in LMIC.
Method We searched MEDLINE, Embase, PscyhINFO, Global Health and Web of Science to identify studies assessing prevalence of perinatal anxiety in LMIC. Studies published since January 2016 were included. Screening and data extraction was conducted independently by two reviewers. Pooled prevalence estimates were calculated using random-effect meta-analyses and sources of heterogeneity explored through subgroup analyses and meta-regression.
Results We screened 9494 titles and abstracts and reviewed 710 full-texts. We included 56 publications (54 studies) in the systematic review and 54 in meta-analysis. The pooled prevalence of self-reported anxiety symptoms was 29.2% (95% CI 24.5–34.2; I2 98.7%; 36 studies; n=28,755) antenatally and 24.4% (95% CI 16.2–33.7; I2 98.5%; 15 studies; n=6370) postnatally. The prevalence of clinically-diagnosed anxiety disorder was 8.1% (95% CI 4.4–12.8; I2 88.1% 5 studies; n=1659) antenatally and 16.0% (95% CI 13.5–18.9; n=113) postnatally.
Conclusion Perinatal anxiety represents a significant burden in LMIC, with one in four women experiencing symptoms during pregnancy or postpartum. Research remains lacking in a significant proportion of LMIC, particularly in the lowest income countries. Further research should guide application of screening tools in clinical settings to identify women with anxiety disorders in order to provide appropriate treatment.
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