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
