Perinatal common mental health disorders among migrant women: a systematic review and meta-analysis

BACKGROUND: Pregnant migrants are particularly vulnerable to mental illness because they are exposed to stressors including conflict, poverty, and discrimination. We aimed to assess the global prevalence of perinatal mental health disorders or substance use among migrant women. METHODS: We searched MEDLINE, Embase, PsycINFO, CENTRAL, Global Health, Scopus, and Web of Science for studies published from inception until July 8, 2022. Cohort, cross-sectional, and interventional studies with prevalence data for any mental illness in the perinatal period or substance use in pregnancy were included. The primary outcome was the prevalence of perinatal mental health disorders amongst migrant women globally. A random-effects meta-analysis was used to calculate pooled prevalence estimates. PROSPERO: CRD42021226291. RESULTS: 18,650 studies were retrieved, of which 135 studies (comprising data from 621,995 participants) met the inclusion criteria. The pooled prevalence of perinatal depressive disorders was 24·2% (range 0·5-95·5%; I2 98·8%; τ2 0·01) among all migrant women, 32·5% (1·5-81·6; 98·7%; τ2 0·01) among forced migrants, and 13·7% (4·7-35·1; 91·5%; τ2 0·01) among economic migrants (p < 0·001). The pooled prevalence of perinatal anxiety disorders was 19·6% (range 1·2-53·1; I2 96·8%; τ2 0·01) among all migrants. The pooled prevalence of perinatal post-traumatic stress disorder (PTSD) among all migrant women was 8·9% (range 3·2-33·3; I2 97·4%; τ2 0·18). The pooled prevalence of perinatal PTSD among forced migrants was 17·1% (range 6·5-44·3; I2 96·6%; τ2 0·32). CONCLUSIONS: One in four migrant women who are pregnant or postpartum experience perinatal depression, one in five perinatal anxiety, and one in 11 perinatal PTSD. The burden of perinatal mental illness appears higher amongst forced migrant women compared to economic migrants. These findings highlight the need for community-based perinatal mental health screening and access to interventions that are culturally sensitive. KEY MESSAGES: • Women who are forced migrants have a higher prevalence of perinatal depressive disorders compared with women who are economic migrants; forced migrants also experience a high burden of PTSD. • The findings highlight the need for culturally sensitive mental health screening and care for migrant women who are pregnant or postpartum, particularly for forced migrants.