Search Strategy- Pregnancy and birth complications and long-term adverse maternal mental health outcomes: a systematic review and meta-analysis protocol

The rate of maternal mortality has declined significantly across countries in comparison to the burden of morbidity, which continues to remain a significant public health challenge. The World Health Organization (WHO) reports that 15% of all pregnant women will experience potentially fatal complications that would necessitate medical attention. The five most direct obstetric complications (preeclampsia, eclampsia, postpartum hemorrhage, puerperal infection, and abortion) accounted for 27 million morbidity episodes in 2015. Existing studies have established an association between these complications and an increased risk of adverse mental health outcomes in the immediate postpartum period. However, there is no clear understanding as to whether such pregnancy and birth complications increase the risk of adverse mental health outcomes in the longer term. Research on long-term mental outcomes following pregnancy and birth complications is scarce and findings are inconsistent. As little is known about this topic, a systematic review and meta-analysis of population-specific studies attending to the relationship between pregnancy and birth complications and maternal mental health beyond the customary 6 weeks postpartum is warranted. The findings of this review will provide an overview of the current state of knowledge regarding the question of whether having a complicated pregnancy or birth is a separate risk factor for poor mother mental health outcomes beyond the immediate postpartum period.