Psychological symptom clusters in pregnant women: a scoping review

Pregnancy exposes women to a wide range of psychological experiences that can carry deleterious consequences. Individual pregnancy-related psychological symptoms have been studied extensively, yet how symptoms group together is still unclear. This scoping review sought to map the composition, measurement tools, and analytical approaches used to identify psychological symptom clusters in pregnant women.

Adhering to the PRISMA-ScR Checklist, literature searches were conducted across 7 databases: PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, Wan Fang, and CNKI. The inclusion criteria were determined based on the study participants, concepts, and contexts. The data were retrieved from inception to July 1, 2024. Search selections and data extraction were conducted independently by two reviewers.

A total of 25 articles met the inclusion criteria. Studies were conducted in 12 countries, mostly in Asia (n = 16) and Europe (n = 7), and most employed a cross-sectional design (n = 24). A single-symptom measurement scale (n = 20) and factor analysis (n = 24) were the most frequently used assessment methods. The reported psychological symptom clusters were classified into 5 categories; the anxiety (n = 10) and depression clusters (n = 5) were the most commonly identified. Predictors were categorized into 3 domains: sociodemographic, clinical, and psychological characteristics.

Further research should focus on evaluating the internal consistency of symptom clusters, developing standardized tools to assess psychological symptom clusters in pregnant women, and exploring new analytical methods to improve clusters identification and uncover underlying biological mechanisms. Additionally, priority should be given to the creating and implementing evidence-based, standardized protocols for managing these symptom clusters during pregnancy.