A systematic review of the influence of hypertensive disorders of pregnancy on the mental health of expectant mothers in Nigeria

Hypertensive disorders of pregnancy (HDP) are a major contributor to maternal morbidity and mortality in Nigeria, yet their relationship with maternal mental health remains insufficiently synthesized. This systematic review maps and synthesizes evidence on depression, anxiety, and psychological distress among pregnant women with HDP in Nigeria. The review aimed to identify, describe, and thematically synthesize empirical studies examining mental health outcomes among Nigerian women with HDP, and to highlight key gaps in research and practice. A systematic review was conducted following the PRISMA guideline. Six electronic databases (PubMed, Scopus, AJOL, ScienceDirect, CINAHL, and PsycINFO) and grey literature sources were searched for studies published between 2015 and 2025. Findings were synthesized using thematic analysis. Eighteen studies met the inclusion criteria. Across studies, HDP was consistently associated with poorer mental health outcomes, particularly depression, anxiety, pregnancy-related anxiety, and psychological distress. Women with HDP were more likely to report adverse psychological outcomes compared with normotensive pregnant women. Key determinants of mental health outcomes included low socioeconomic status, intimate partner violence, marital dissatisfaction, poor social support, and low educational attainment. Evidence indicates a consistent association between HDP and adverse mental health outcomes among pregnant women in Nigeria, although the evidence base remains methodologically limited. Integration of routine mental health screening and scalable psychosocial support into antenatal care, particularly through task-sharing approaches, is urgently required.