Coping, wellbeing, and psychopathology during high-risk pregnancy: A systematic review. (January 2023)

• Record Type: Journal Article
• Authors: Williamson, Shannon P.; Moffitt, Robyn L.; Broadbent, Jaclyn; Neumann, David L.; Hamblin, Peter S.
• Is Part Of: Midwifery. Volume 116(2023)
• Publication Date: 2023-01
• Subjects: Depression -- Anxiety -- Stress -- Quality-of-life -- High-risk pregnancy -- Pregnancy complication; Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2022.103556
• Languages: English
• ISSNs: 0266-6138

Abstract

Highlights: High-risk pregnancy can negatively impact on coping, wellbeing, and mental health. High-risk pregnancy can lead to higher symptoms of psychopathology in mothers. Protective factors include facilitating empowerment and optimism and active coping. Abstract: Objective: Complications during pregnancy can negatively impact the physical and psychological wellbeing of mothers. This systematic review aimed to synthesise evidence which has examined the impact of high-risk conditions developed during pregnancy on women's coping, wellbeing, and symptoms of psychopathology. Data sources: Medline (Ovid), PsycINFO (ProQuest), Scopus, Web of science, AMED (Ebsco), CINAHL (Ebsco) and ProQuest databases were searched in May 2021 with no restrictions on publication date. Study selection: English-language literature was reviewed to identify 31 articles. Data extraction: Fifteen articles examined Gestational Diabetes Mellitus (GDM: 48%), nine examined multiple high-risk pregnancy conditions (29%), four examined Hypertensive disorders of pregnancy, Preeclampsia (PE: 13%), two did not specify the condition examined (7%), and one examined Pregnancy-Related Acute Kidney Injury (PR-AKI: 3%). The most common study design was quantitative, non-randomised, and survey-based. Data synthesis: Twenty-seven articles (87%) reported a high-risk pregnancy resulted in decreased wellbeing and ability to cope, and increased symptoms of psychopathology. The remaining four articles (13%) reported no difference in wellbeing or psychopathology outcomes for women experiencing high-risk compared to healthy pregnancies. Moreover, hypertensive disorders and GDM were associated with ineffective submissive or avoidant coping, reduced wellbeing, and quality-of-life, and exacerbated symptoms of anxiety and depression. Conclusion: High-risk pregnancy negatively impacts coping, wellbeing, and psychopathology, and preventive and supportive interventions to mitigate this should focus on empowering women to feel optimistic and in control of their pregnancy. A holistic and culturally sensitive approach is recommended, where pregnant women (and their partners or support people) are involved in healthcare decisions, thus promoting wellbeing, coping, satisfaction, and improved treatment outcome.