A systematic review of the influence of diabetes in pregnancy on the mental health of expectant mothers in Nigeria
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Diabetes in pregnancy is increasingly recognized as an important contributor to adverse maternal mental health outcomes; yet evidence from Nigeria remains fragmented. This systematic review mapped the existing literature on the mental health and well-being of Nigerian women with diabetes in pregnancy and identified the major psychosocial and contextual factors associated with psychological distress. A systematic review methodology guided by the Joanna Briggs Institute framework and PRISMA-SR guidelines was employed. Six electronic databases (PubMed, Scopus, African Journals Online (AJOL), ScienceDirect, Google Scholar, and the Cochrane Library) and grey literature sources were searched for studies published between January 2020 and April 2026, and the findings were synthesized thematically. A total of 12 studies met inclusion criteria. The evidence demonstrated consistently elevated levels of depression, anxiety, emotional distress, and impaired psychological well-being among women with diabetes in pregnancy compared with normoglycemic pregnant populations. Poor glycemic control, previous mental health problems, low social support, financial hardship, and poor health literacy emerged as major determinants of psychological distress. Fear of adverse maternal and fetal outcomes, stigma, and inadequate partner support further intensified emotional vulnerability. Health-system limitations, including poor awareness of gestational diabetes, inconsistent screening practices, and the absence of integrated mental health services within antenatal care, contributed substantially to psychological burden. Coping strategies were predominantly informal, with spirituality and family support serving as major protective mechanisms. Diabetes in pregnancy carries a considerable mental health burden among Nigerian women. The review highlights an urgent need for integrated maternal mental health screening, psychosocial support services, and culturally responsive interventions within diabetes-in-pregnancy care pathways in Nigeria.
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