A global review of pregnancy mental health finds that common mental disorders are widespread, but the strongest signal points beyond biology to safety, support, and protection from intimate partner violence.
Study: The global burden and risk factors of common mental disorders in pregnant women: a systematic review and meta-analysis. Image Credit: GrAl / Shutterstock
In a recent study published in the journal Scientific Reports, a group of researchers evaluated the pooled prevalence of common mental disorders (CMDs) in pregnant women across included studies from Africa, Asia, and South America and identified the major contributing risk factors.
Pregnancy Mental Health Burden Background
Around 30% of expectant mothers in the included studies experienced symptoms of common mental disorders or significant psychological distress, which can disrupt their daily routines, relationships, and affect maternal health.
Pregnant women are often silently suffering from stress associated with anxiety, depression, insomnia, and other forms of psychological distress. These conditions, commonly grouped as CMDs, can interfere with prenatal care, increase pregnancy complications, and negatively affect infant development. Despite increased public awareness of these issues, the actual screening process to identify them remains inconsistent across countries.
Additional studies from underrepresented regions are still needed to understand how these issues affect women globally and to identify preventive measures.
CMD Pregnancy Meta-Analysis Study Design
A systematic review and meta-analysis were performed to determine the pooled prevalence of CMDs among women during pregnancy. Studies published before January 2024 were included in this review, and databases used to search for relevant articles were PubMed, Embase, PsycINFO, Web of Science, Google Scholar, and Health InterNetwork Access to Research Initiative. The search terms were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and therefore contained both pregnancy-related terminology and mental health terminology, such as anxiety, depression, stress, and psychological distress.
Observational studies, including cross-sectional, cohort, and case-control studies, were eligible if they reported data on either the prevalence or risk factors associated with CMDs and were conducted within the context of pregnancy. Only articles written in English and containing complete data were included in the systematic review. Reviewers screened the articles, extracted the data, and assessed the quality of the studies using the Newcastle-Ottawa Scale.
The analysis included 18 studies involving 17,380 pregnant women from Africa, Asia, and South America. Different screening instruments were used across studies, including the Self-Reporting Questionnaire-20, Clinical Interview Schedule-Revised, Mini-International Neuropsychiatric Interview, and Edinburgh Postnatal Depression Scale. Statistical analyses were done using STATA version 11. A random-effects model estimated pooled prevalence and associated risk factors, while subgroup analyses explored regional and methodological differences.
CMD Prevalence and Regional Findings
The analysis revealed that CMDs affect a substantial proportion of pregnant women in the included evidence base. The pooled prevalence across the included studies was estimated at 31.59%, meaning nearly one out of every three pregnant women experienced significant psychological distress during pregnancy. This finding highlights that mental health challenges during pregnancy are not isolated cases but a widespread public health concern that could potentially affect large numbers of families globally.
Considerable regional variation was observed across continents. South America showed the highest prevalence at 40.30%, followed by Africa at 30.30%, while Asia reported a comparatively lower prevalence of 22.96%. These differences may reflect variations in healthcare access, social support systems, economic conditions, cultural attitudes toward mental health, and screening practices. In many low- and middle-income settings, limited mental health services and financial stress may contribute to the higher burden.
The studies also showed large differences in prevalence depending on the diagnostic tools used. Research using the Self-Reporting Questionnaire-20 reported the highest pooled prevalence of 38.05%, whereas studies using the Mini-International Neuropsychiatric Interview reported lower prevalence estimates of 10.68%. This suggests that mental health screening methods strongly influence reported outcomes and may partly explain inconsistencies between studies worldwide.
Subgroup analysis based on sample size found no meaningful difference between smaller and larger studies. Studies with fewer than 500 participants had a higher percentage of CMDs (32.42%) than those with more than 500 participants (30.53%). This finding suggests that sample size alone did not explain the variation in prevalence estimates across studies.
Intimate Partner Violence Risk Findings
Potential risk factors for CMDs were family history of mental illness, chronic medical problems, emotional abuse, unplanned pregnancy, prior abortions, and intimate partner violence. Of the risk factors listed, the only one that was statistically significant in relation to CMDs was intimate partner violence. Pregnant women who were exposed to intimate partner violence had about 2.6-fold higher odds of CMDs compared to non-abused pregnant women.
Maternal mental health is significantly influenced by the social environment. If there is emotional trauma, fear, or domestic violence, the mother will be under more stress during her pregnancy, and this can negatively impact both the mother and the fetus. Untreated psychological distress may reduce antenatal care attendance, worsen nutrition, impair sleep, and increase the likelihood of poor birth outcomes such as low birth weight or preterm birth.
Statistically significant heterogeneity across all included studies was observed, as was evidence of publication bias. However, the results of the sensitivity analyses indicated that no individual study appeared to disproportionately influence the overall pooled estimate, and therefore, the overall estimates appear to have been stable despite the different methods used in the studies. Because heterogeneity was very high and publication bias was detected, the pooled prevalence should be interpreted as an approximate estimate rather than a definitive global rate.
Antenatal Mental Health Care Implications
The study shows that CMDs represent a major maternal mental health burden among pregnant women, affecting nearly one-third of expectant mothers across the included studies. The findings illustrate the regional disparity in CMD prevalence, as well as the influence of health inequity, socioeconomic stress or disadvantage, and cultural influences in maternal mental health.
A strong association with intimate partner violence as a risk factor was an additional finding of this study, and it indicates that mothers should have a safe and supportive environment while pregnant. Maternal mental health should not be separated from social well-being and access to healthcare.
Improving access and availability to routine screening for mental health, counseling services, and violence prevention programs through antenatal care could lead to improved maternal and infant health outcomes, although further research from underrepresented regions is needed to strengthen truly global estimates.
Journal reference:
Tinsae, T., Fentahun, S., Medfu, G., Shumet, S., Tadesse, G., Koye, S., Andualem, F., Nakie, G., Rtbey, G., & Getinet, W. (2026). The global burden and risk factors of common mental disorders in pregnant women: A systematic review and meta-analysis. Scientific Reports. DOI: 10.1038/s41598-026-53149-4 https://www.nature.com/articles/s41598-026-53149-4