The impact of disasters on maternal mental health: a systematic review

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: 30% to over 200% increase in maternal mental health problems

• Primary Outcome: Increased risk of maternal mental health problems (depression, anxiety, stress, PTSD) following disaster exposure

• Nnt Or Sensitivity: 7-10 fold increase in PTSD odds among highly exposed pregnant women

• Confidence Interval: Not reported in abstract

Clinical Application

Screening and intervention programs feasible in Australian healthcare system with established maternal health services Highly relevant given Australia's exposure to natural disasters (bushfires, floods, cyclones). Could inform RACGP guidelines for antenatal care in disaster-affected areas and support PBS-funded mental health interventions for pregnant women Pregnant women in disaster-prone areas or those exposed to natural or man-made disasters

Abstract

BACKGROUND: The vulnerability of maternal mental health is increasing with the frequent increase in natural and man-made disasters, yet evidence remains fragmented. We aimed to synthesise quantitative evidence on the impact of disaster exposure on maternal mental health and related pregnancy outcomes. METHODS: We systematically searched 12 electronic databases, nine sub-databases, and additional web sources for the studies published between 1995 and 2025. We included studies that assessed the impact of disaster exposure during pregnancy and provided quantitative outcomes for depression, anxiety, stress, posttraumatic stress disorder (PTSD), or adverse pregnancy outcomes. RESULTS: Of 18 604 studies, 24 studies met the inclusion criteria. Natural disasters were the highest group (n = 16), including earthquakes (n = 8), floods/cyclone/hurricane (n = 7), and wildfire (n = 1), followed by man-made disaster (n = 7), including conflict/war/terrorism (n = 5), nuclear disaster (n = 1), plane crash (n = 1), and war (n = 1), and one hybrid disaster. Disaster showed a consistent increase in the risk of depression, anxiety, stress, and PTSD among pregnant women, with effects persisting up to six years post-disaster event. Across studies, disaster exposure increased maternal mental health problems by approximately 30% to over 200%, and PTSD odds increased seven to 10-fold among highly exposed pregnant women. Three studies reported that both depression and PTSD during pregnancy were associated with adverse pregnancy or early child outcomes, suggesting potential intergenerational effects. CONCLUSIONS: Disasters exert enduring and profound impacts on maternal mental health, with consequences cascading across both mother and child. Urgent, cost-effective and disaster-informed policies are needed to mitigate such long-term impacts. REGISTRATION: PROSPERO: CRD42023445559.

References

1. 1.Seema, M., Afoakwah, C., Tuzel, E., & Byrnes, J. (2026). The impact of disasters on maternal mental health: a systematic review. Journal of Global Health, 16, 04126. https://doi.org/10.7189/jogh.16.04126