Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2022; 12(9): 1233-1254
Published online Sep 19, 2022. doi: 10.5498/wjp.v12.i9.1233
Mental health impact on Black, Asian and Minority Ethnic populations with preterm birth: A systematic review and meta-analysis
Gayathri Delanerolle, Yu-Tian Zeng, Peter Phiri, Thuan Phan, Nicola Tempest, Paula Busuulwa, Ashish Shetty, Vanessa Raymont, Shanaya Rathod, Jian-Qing Shi, Dharani K Hapangama
Gayathri Delanerolle, Nuffield Department of Primary Care Health Science, University of Oxford, Oxford OX3 7JX, United Kingdom
Gayathri Delanerolle, Peter Phiri, Shanaya Rathod, Research and Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
Yu-Tian Zeng, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
Peter Phiri, Psychology Department, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom
Thuan Phan, Nicola Tempest, Paula Busuulwa, Dharani K Hapangama, Department of Women's and Children's Health, University of Liverpool, Liverpool L7 8TX, United Kingdom
Nicola Tempest, Dharani K Hapangama, Gynaecology Directorate and Hewitt Centre for Reproductive Medicine, Liverpool Women's NHS Foundation, Liverpool L8 7SS, United Kingdom
Ashish Shetty, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London W1T 4AJ, United Kingdom
Vanessa Raymont, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
Jian-Qing Shi, National Centre for Applied Mathematics Shenzhen, Shenzhen 518055, Guangdong Province, China
Jian-Qing Shi, Department of Statistics, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
Author contributions: Delanerolle G and Hapangama DK developed the systematic review protocol and embedded this within the ELEMI project’s evidence synthesis phase; Delanerolle G, Zeng Y, Phan T, Shi JQ and Hapangama DK wrote the first draft of the manuscript; Delanerolle G, Phan T, Zeng Y, Hapangama DK, Shi JQ and Phiri P shared database searches, study selection and extraction for analysis; Zeng Y, Shi JQ and Delanerolle G conducted the analysis; all authors critically appraised and commented on previous versions of the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: Phiri P has received research grant from Novo Nordisk, and other, educational from Queen Mary University of London, other from John Wiley & Sons, other from Otsuka, outside the submitted work. Rathod S reports other from Janssen, Lundbeck and Otsuka outside the submitted work. All other authors report no conflict of interest. The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or the Academic institutions.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peter Phiri, BSc, PhD, RN, Academic Fellow, Director, Research and Innovation, Southern Health NHS Foundation Trust, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton SO30 3JB, United Kingdom. peter.phiri@southernhealth.nhs.uk
Received: March 21, 2022
Peer-review started: March 21, 2022
First decision: May 30, 2022
Revised: June 16, 2022
Accepted: August 5, 2022
Article in press: August 5, 2022
Published online: September 19, 2022
Processing time: 182 Days and 16.4 Hours
Abstract
BACKGROUND

Preterm birth (PTB) is one of the main causes of neonatal deaths globally, with approximately 15 million infants are born preterm. Women from the Black, Asian, and Minority Ethnic (BAME) populations maybe at higher risk of PTB, therefore, the mental health impact on mothers experiencing a PTB is particularly important, within the BAME populations.

AIM

To determine the prevalence of mental health conditions among BAME women with PTB as well as the methods of mental health assessments used to characterise the mental health outcomes.

METHODS

A systematic methodology was developed and published as a protocol in PROSPERO (CRD42020210863). Multiple databases were used to extract relevant data. I2 and Egger’s tests were used to detect the heterogeneity and publication bias. A trim and fill method was used to demonstrate the influence of publication bias and the credibility of conclusions.

RESULTS

Thirty-nine studies met the eligibility criteria from a possible 3526. The prevalence rates of depression among PTB-BAME mothers were significantly higher than full-term mothers with a standardized mean difference of 1.5 and a 95% confidence interval (CI) 29%-74%. The subgroup analysis indicated depressive symptoms to be time sensitive. Women within the very PTB category demonstrated a significantly higher prevalence of depression than those categorised as non-very PTB. The prevalence rates of anxiety and stress among PTB-BAME mothers were significantly higher than in full-term mothers (odds ratio of 88% and 60% with a CI of 42%-149% and 24%-106%, respectively).

CONCLUSION

BAME women with PTB suffer with mental health conditions. Many studies did not report on specific mental health outcomes for BAME populations. Therefore, the impact of PTB is not accurately represented in this population, and thus could negatively influence the quality of maternity services they receive.

Keywords: Preterm labor; Preterm birth; Black, Asian, and Minority Ethnic; Mental health; Women’s health; Wellbeing

Core Tip: Preterm birth is a multi-etiological condition and a leading cause of perinatal mortality and morbidity. This study demonstrates the mental health impact due to preterm birth among the Black, Asian and Ethnic minority women. There is minimal research available at present around this subject matter, and this important disease sequelae.