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

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.