key: cord-0292701-8702jfz0 authors: Dol, J.; Campbell-Yeo, M.; Leahy-Warren, P.; Dennis, C.-L. title: Protocol for a bibliometric analysis and mapping review of parental anxiety and postpartum depression across the perinatal period date: 2021-05-10 journal: nan DOI: 10.1101/2021.05.08.21256829 sha: bbccc96673412f22183f06a764c0a92ca8cf40c0 doc_id: 292701 cord_uid: 8702jfz0 Objective: The objective of this bibliometric analysis and mapping review is to describe the characteristics and trends in published research on anxiety and perinatal depression across the perinatal period from emergence to end of 2020. Introduction: There has been significant growth in the literature around depression and anxiety across the perinatal period over the past decades. To focus future research and identify gaps, it is important to explore current patterns and trends in the current literature. Inclusion criteria: All published literature with an English abstract on perinatal anxiety and depression as a primary or secondary outcome will be included up until December 31, 2020. Quantitative and qualitative studies will be eligible, with reviews, discussion papers, editorials, dissertations, conference abstracts, books/book chapters, book reviews, animal studies, and commentaries excluded. Methods: Titles and abstracts will be screened by two reviewers with disagreements resolved through discussion. Data will be extracted from only the abstracts by one reviewer with 20% verified by a second reviewer. Meta-data of the articles will also be extracted. A narrative summary will accompany the charted results and will describe how the results relate to the reviews objective. Titles and abstracts will be screened by two reviewers with disagreements resolved through discussion. Data will be extracted from only the abstracts by one reviewer with 20% verified by a second reviewer. Meta-data of the articles will also be extracted. A narrative summary will accompany the charted results and will describe how the results relate to the reviews objective. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. Throughout the perinatal period from pregnancy to the first year postpartum, women experience significant physical, psychological and social changes which may increase their risk of a mental illness, including anxiety and depression. 1 Onset. 2 While there is no specific recognition in the DSM-V of anxiety specific to the perinatal experience, anxiety in all populations is the most common mental illnesses diagnosed each year. Perinatal depression is a non-psychotic depressive episode that begins in or extends from pregnancy into the postpartum period, ranging from minor depressive symptoms to a clinical diagnosis. 3 Symptoms can include anxiety, guilt, negative maternal attitudes and attachment, poor parenting self-efficacy and coping skills, lasting up to 14 months postpartum. 3 While often comorbid with perinatal depression, perinatal anxiety is a separate mental health concern, shaped by fear and worry, rather than depressive thoughts, and can emerge as generalized anxiety, panic disorders, obsessive compulsive disorder, or post-traumatic stress disorder. 4 Anxiety can manifest itself as several symptoms, including "excessive and persistent fear, worry, and tension and regularly includes physical symptoms such as sleeping difficulties and inability to concentrate. Severe symptoms include panic and recurrent intrusive thoughts or images, often related to the harm of their child" (p.486). 5 While anxiety and depression may be pre-existing or may emerge in the antenatal period, studies have shown that it is important to re-assess for possible anxiety and depression in the postpartum period due to the changes that occur after birth and variation in symptoms across the perinatal period. 6, 7 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint Across the perinatal period, both anxiety and depression have shown to have high prevalenceup to 39% of pregnant and postpartum women have experienced anxiety symptoms and related disorders 8, 9 and up to 24% of pregnant and 16% of postpartum women experience depressive symptoms. 10-12 It is not just women who experience anxiety and depression in the perinatal period, the prevalence of postpartum depression and postpartum anxiety symptoms for fathers is estimated around 10% and 18%, respectively, [13] [14] [15] yet only 3% of fathers seek treatment for mental health disorders. 16 Beyond prevalence, the literature on anxiety and depression across the perinatal period has focused on multifactorial risk factors that often guide the creation of preventive interventions 17,18 and treatments 19,20 as well as the impact on numerous maternal 21 and paternal outcomes. 22 Importantly, research has shown that perinatal mental illness in both mothers and fathers can negatively influence child outcomes including emotional negativity and behaviour problems. 21, 23, 24 There has been significant growth in the literature around depression and anxiety across the perinatal period over the past decades, with significant variation in definition and subsequent measurements of these mental health outcomes [25] [26] [27] as well as co-reported psychosocial outcomes. 9, 28, 29 To focus future research and identify gaps, it is important to explore current patterns and trends in the current literature. To do this, we will use a bibliometric analysis approach, which seeks to comprehensively explore patterns in publications in a given research area, including trends over time and the influences of contributions by citations. 30 Bibliometric analyses has been used across a variety of academic disciplines to provide a broad overview of the current literature to provide description, evaluation, and scientific and technological monitoring. 30 This will be combined with a mapping review to map and categorize existing evidence in order to highlight gaps in the literature to inform future research. 31, 32 While there . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint have been many reviews on anxiety and depression across the perinatal period, none to date have used this approach to map the evolution of published literature on perinatal mental health to characterize research outputs, distribution, and contributions. A preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews and PROSPERO was conducted and no current or underway systematic reviews, scoping reviews, or bibliometric analysis on the topic were identified. The specific objectives of the mapping review are to: 5. Identity type of participants (e.g., healthy population, high-risk, maternal, paternal, or other) 6 . Identify measurement tools used to measure anxiety and depression and explore timing of when measurement took place (e.g., antenatal vs. postpartum) 7. Map co-reported perinatal psychosocial outcomes (e.g., stress, maternal self-efficacy, social support, etc.). . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint This study uses a bibliometric approach 30,33 combined with a mapping review. 31 The search strategy will aim to locate all published literature using several databases: PubMed, Web of Science, CINAHL, PsycINFO, and Scopus. The search strategy has been developed in consultation with a health science librarian. The search strategy, including all identified keywords and index terms, will be adapted for each included database. All published literature with an English abstract on perinatal anxiety and depression will be considered for inclusion published since database inception to December 31, 2020. As most non-English articles have an English abstract, this will enhance the representativeness of the findings. An article will be included if it reports on perinatal depression or perinatal anxiety as a primary or secondary outcome as stated in the abstract. Eligible peer review literature will include randomized controlled trials, observational studies (e.g., cross-sectional, cohort, etc.), and quasi-experimental (e.g., before and after studies and interrupted time-series studies). Qualitative studies will also be considered with no limit on type of approach (e.g., . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint phenomenology, grounded theory, qualitative description). Reviews, discussion papers, editorials, dissertations, conference abstracts, books/book chapters, book reviews, animal studies, and commentaries/letters to the editors will be excluded. Reviews (e.g., systematic reviews, umbrella reviews, meta-analysis) will be mined for original studies to ensure full capture of eligible studies. Following the search, all identified citations will be collated and uploaded into Covidence and duplicates removed. For feasibility, titles and abstracts will be screened by two reviewers against the inclusion criteria for the review with disagreements resolved through discussion or a third reviewer. Articles with no abstract available will be documented and excluded. Due to the vast amount of literature likely to be identified, full-text screening will not occur, which has been used before in other bibliometric analyses and mapping reviews, 31, 34, 35 all screening will occur based on title and abstract. Reasons for exclusion of sources of evidence at the data extraction stage that do not meet the inclusion criteria will be reported in the final report. The results of the search and the study inclusion process will be reported in full using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). 36 Data will be extracted from only the abstracts of included papers by one independent reviewer using a data extraction tool developed by the authors hosted in REDCap. 37 From the included studies, 20% will be randomly selected to be verified by a second reviewer with disagreements resolved through discussion or a third reviewer. 38 The data extracted will include specific details about the outcomes identified above. Meta-data of the articles will also be extracted from the included studies. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint 7 A draft extraction form is in Appendix I and will be piloted by at least two reviewers with 10 articles to ensure completeness and usability, similar to other bibliometrics analyses. 39 The draft data extraction tool will be modified and revised as necessary prior to full data extraction. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewers. As this is a bibliometric analysis and mapping review, no critical appraisal of the articles will occur. 31, 33 Bibliographic information collected will include the names and affiliations of the corresponding author, year of publication, country where study occurred, and journal. The number of citations for each article will be obtained from both Scopus and Web of Science databases. Information regarding the study characteristics will be recorded on the objective, study design, topic, type of participants, primary measurement tools, measurement timing, and co-reported postpartum outcomes. Any data that is not able to be ascertained from the abstract will be classified as missing. Descriptive statistics will be based on percentages for categorical variables and medians and means for continuous variables. Articles will be grouped together based on whether it discussed anxiety or depression, or both and whether the study sample included antenatal or postnatal or both participants and by gender. A narrative summary will accompany the charted results and will describe how the results relate to the reviews objective. Exploration of the bibliometric data will be conducted using relevant software (e.g., bibliometrix in R, VOSviewer, Excel, SPSS, or other). . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint Perinatal mental illness: Definition, description and aetiology American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th Editio Prevalence and characteristics of Postpartum Depression symptomatology among Canadian women: A cross-sectional study Women's experiences with postpartum anxiety disorders: A narrative literature review Identifying women at risk for postpartum anxiety: a prospective population-based study Trajectories of perinatal depressive and anxiety symptoms in a community cohort Depression and anxiety during pregnancy and six months postpartum: A follow-up study Perinatal anxiety disorder prevalence and incidence Maternal perinatal anxiety: A review of prevalence and correlates Perinatal Depression: Prevalence, Risks, and the Nutrition Link-A Review of the Literature Identifying women at risk for sustained postpartum anxiety Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis Anxiety among fathers during the prenatal and postpartum period: a meta-analysis An examination of fathers' mental health help seeking: A brief report Treatment of postpartum depression: Clinical, psychological and pharmacological options Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes When fathers begin to falter: A comprehensive review on paternal perinatal depression The relationship between infant-feeding outcomes and postpartum depression: A qualitative systematic review Maternal postnatal depression and anxiety and their association with child emotional negativity and behavior problems at two years Anxiety measures validated in perinatal populations: A systematic review Postpartum Depression Screening Tools: A Review Anxiety scales used in pregnancy: systematic review Wan Emilin WMA. Magnitude and risk factors for postpartum symptoms: A literature review International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity Correlates of ante-and postnatal depression in fathers: A systematic review Bibliometric analysis of scientific and technological research: A user's guide th the methodology A typology of reviews: An analysis of 14 review types and associated methodologies Meeting the review family: exploring review types and associated information retrieval requirements Conducting systematic literature reviews and bibliometric analyses A comprehensive categorical and bibliometric analysis of published research articles on pediatric pain from 1975-2010 Electronic Commerce Research Profiles: Comparing E-Commerce and Information Systems Journals The PRISMA 2020 statement: an updated guideline for reporting systematic reviews Research electronic data capture (REDCap) -A metadata-driven methodology and workflow process for providing translational research informatics support Adverse childhood experiences (ACEs) research: A bibliometric analysis of publication trends over the first 20 years International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2021. ; https://doi.org/10.1101/2021.05.08.21256829 doi: medRxiv preprint