A Systematic Review and Meta-analysis of Depression in Postpartum Women in a Low-income Country; Ethiopia, 2020

Mogesie Necho,Yemiyamirew Getachew,Merid Abadisharew

doi:10.2174/1874944502013010595

Abstract

Background: Maternal mental health in the postpartum period is essential for the optimal development of the newborn. Despite this, a shortage of concrete evidence exists regarding it. Methods: PubMed, Scopus, and EMBASE were investigated with no time limitation. A manual search for a reference list of articles was also done. Relevant data were extracted using the Meta XL package and analysis was done using Stata-11 meta-prop package. Heterogeneity was checked with Cochran's Q-statistics and the Higgs I 2 test. Results: Sixteen studies were included. The average prevalence of postpartum depression was 21.9%. The pooled prevalence was found to be higher in studies assessed with SRQ-20, i.e 24.6% than studies assessed using PHQ-9, which was 18.9%. Moreover, the pooled prevalence was slightly higher in southern Ethiopia (22.6%) than Addis Ababa (21.2%). Poor marital relation (pooled aOR= 3.56) (95% CI: 2.50, 4.63), unplanned pregnancy (pooled aOR=3.48) (95% CI: 2.18, 4.79), previous history of depression (pooled aOR= 4.33) (95% CI: 2.26, 6.59), poor social support (pooled aOR= 4.5) (95% CI: 3.34, 5.56), and domestic violence were among the associated factors for postpartum depression. Conclusion: More than one in five women were found to have postpartum depression and factors such as poor marital relations, history of depression, poor social support, domestic violence, and unplanned pregnancy were observed to be associated with it. Therefore, maternal postnatal care services should integrate this essential health concern.

Highlights

Maternal mental health in the postpartum period is essential for the optimal development of the newborn
Contrary to the subgroup analysis result of a worldwide meta-analysis study [8] that observed the pooled estimated prevalence of postpartum depression to be similar across the different measurement tools for Postpartum Depression (PPD), the present study revealed that pooled prevalence of postpartum depression was higher in studies as measured with SRQ-20 (24.6%%) than the result with PHQ-9 (18.9%)
The pooled estimate of postpartum depression was higher in studies that used SRQ-20 (24.6%) than studies that used PHQ-9

Summary

Introduction

Maternal mental health in the postpartum period is essential for the optimal development of the newborn. Women with depression in the postpartum period show manifestations like sleep disturbance, change in appetite patterns, feeling of sadness, recurrent guilty feeling, crying, low energy, and unease feelings of anxiety and suicidal ideas [1]. Organization (WHO) identified that 20-40% of childbearing women in the developing world sustained depression in the antepartum and postpartum period at a given time [4]. 19% of postnatal women in low and middle-income countries [5, 6] and one among twenty postnatal women in Ethiopia [7] develop postpartum depression. Different studies across the world have reported different prevalence rates for postpartum depression

Methods

Results

Discussion

Conclusion