Estimation of sleep problems among pregnant women during COVID-19 pandemic: a systematic review and meta-analysis

Abstract

ObjectiveTo estimate the sleep problems among pregnant women during the COVID-19 pandemic.Eligibility criteriaEnglish, peer-reviewed, observational studies published between December 2019 and July 2021 which assessed and reported sleep problem prevalence using a valid and reliable measure were included.Information sourcesScopus, Medline/PubMed Central, ProQuest, ISI Web of Knowledge and Embase.Risk of bias assessment toolThe Newcastle-Ottawa Scale checklist.Synthesis of resultsPrevalence of sleep problems was synthesised using STATA software V.14 using a random effects model. To assess moderator analysis, meta-regression was carried out. Funnel plot and Egger’s test were used to assess publication bias. Meta-trim was used to correct probable publication bias. The jackknife method was used for sensitivity analysis.Included studiesA total of seven cross-sectional studies with 2808 participants from four countries were included.Synthesis of resultsThe pooled estimated prevalence of sleep problems was 56% (95% CI 23% to 88%, I2=99.81%, Tau2=0.19). Due to the probability of publication bias, the fill-and-trim method was used to correct the estimated pooled measure, which imputed four studies. The corrected results based on this method showed that pooled prevalence of sleep problems was 13% (95% CI 0% to 45%; p<0.001). Based on meta-regression, age was the only significant predictor of prevalence of sleep problems among pregnant women.Limitations of evidenceAll studies were cross-sectional absence of assessment of sleep problems prior to COVID-19, and the outcomes of the pregnancies among those with and without sleep problems in a consistent manner are among the limitation of the current review.InterpretationPregnant women have experienced significant declines in sleep quality when faced with the COVID-19 pandemic. The short-term and long-term implications of such alterations in sleep on gestational and offspring outcomes are unclear and warrant further studies.PROSPERO registration numberCRD42020181644.