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Meta-Analysis
. 2022 Apr 4;12(4):e056044.
doi: 10.1136/bmjopen-2021-056044.

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

Zainab Alimoradi  1 , Fatemeh Abdi  2 , David Gozal  3 , Amir H Pakpour  4
Affiliations
Meta-Analysis

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

Zainab Alimoradi et al. BMJ Open. .

Abstract

Objective: To estimate the sleep problems among pregnant women during the COVID-19 pandemic.

Eligibility criteria: English, 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 sources: Scopus, Medline/PubMed Central, ProQuest, ISI Web of Knowledge and Embase.

Risk of bias assessment tool: The Newcastle-Ottawa Scale checklist.

Synthesis of results: Prevalence 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 studies: A total of seven cross-sectional studies with 2808 participants from four countries were included.

Synthesis of results: The 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 evidence: All 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.

Interpretation: Pregnant 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 number: CRD42020181644.

Keywords: maternal medicine; obstetrics; sleep medicine.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart of selected studies.
Figure 2
Figure 2
Forest plot regarding the pooled prevalence of sleep problems among pregnant women.
Figure 3
Figure 3
Funnel plot assessing the publication bias among included studies.
Figure 4
Figure 4
Corrected funnel plot based on fill-and-trim method.
Figure 5
Figure 5
Assessment of small-study effect based on jackknife method.
See this image and copyright information in PMC

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