Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries.

Postpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression. To estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016-2021 and combined our findings with a previous meta-analysis of articles published between 1985-2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables. 412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010-0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016-0.242). The global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.

Untreated postpartum depression (PPD) has the potential to cause significant distress or impairment in functioning with a consequent negative impact on a developing child. This study aimed to determine the prevalence of PPD and its associated factors in women attending postpartum primary care clinics. The study setting involved randomly selected three 24-h clinics in Gaborone, the capital city of Botswana. A cross-sectional study was conducted among 295 conveniently sampled postpartum mothers. The Edinburgh Postnatal Depression Scale (EPDS) questionnaire, researcher-designed socio-demographic questions and the Oslo Social Support Scale 3 (OSSS-3) were utilised to collect data on the PPD, demographic factors and social support, respectively. Variables identified to be associated with PPD on bivariate analyses were entered into multivariate analysis to determine factors associated with PPD. The prevalence of PPD was 33.9% (95% CI 28.5% - 39.6%). Factors predictive of PPD included the history of being involved in intimate partner violence (AOR = 4.789 95% CI [2.276-10.077]), poor relationship with the partner's mother (AOR 2.657, [1.080-6.538]), poor and moderate social support (AOR 2.685 [1.013-7.111] and AOR 5.897 [2.140-16.248]), respectively. The high prevalence of PPD highlights the need for routine screening for PPD and its associated factors in antenatal and postnatal clinics. Continued practice of traditional postpartum cultural practices can be recommended as these promote social support and can potentially decrease PPD in our setting. This is the first study to report on the prevalence and factors associated with PPD in Botswana, thus useful in tailoring culturally appropriate interventions.

Background: Postpartum depression (PPD) is one of the most common mental health conditions in new mothers, and negatively impacts newborn care, mother-baby interaction/bonding, and familial relationships. Objective: To identify the prevalence and risk factors of PPD in parturient-delivered babies at a tertiary medical facility in Thailand. Materials and Methods: The present study was a cross-sectional descriptive study conducted at Bhumibol Adulyadej Hospital (BAH), Bangkok, Thailand, between October 2023 and October 2024. Participants were pregnant women who delivered their babies and attended the postpartum clinic at BAH. At the postpartum ward, patients were counseled before signing a written consent form. A Thai version of the Edinburgh Postnatal Depression Scale (EPDS) was used for PPD evaluation at four to six weeks. Demographic and clinical data were collected from the BAH electronic database. Results: Five hundred thirteen participants were recruited in the present study. The mean age was 29.3 years old. The prevalence of PPD was 12.1% (62 out of 513). Risk factors for PPD were being a single mother (adj. OR 7.1, 95% CI 2.5 to 20.2), alcohol drinker (adj. OR 3.7, 95% CI 1.6 to 8.3), neonatal complication (adj. OR 6.6, 95% CI 1.8 to 24.2), premenstrual syndrome (adj. OR 2.7, 95% CI 1.3 to 5.3), no childcare support (adj. OR 5.1, 95% CI 2.2 to 11.7), and previous depression (adj. OR 5.1, 95% CI 1.5 to 16.8). Conclusion: The prevalence of PPD was 12.1%. Risk factors of PPD were a single mother, alcohol drinker, neonatal complication, premenstrual syndrome, inadequate or absent childcare support, no familial psycho-social support, and previous depression.

Background: Postpartum depression is a common psychological problem that occurs after birth. It has become especially prevalent in the era of the COVID-19 pandemic. Several factors contribute to postpartum depression. However, a limited study evaluated factors contributing postpartum depression among mothers during the COVID-19 pandemic, particularly in Indonesia.Purpose: This study aimed to explore postpartum depression among mothers and its contributing factors during the COVID-19 pandemic.Methods: This study adopted a cross-sectional design. A total of 110 postpartum mothers were recruited by accidental sampling with the following inclusion criteria: mothers between one month and one year after birth, married, a singleton birth and the baby alive, and the mother is healthy with no complications. The Edinburgh Postnatal Depression Scale was used to measure postpartum depression. Descriptive statistics, t-test, Fisher exact test, one-way ANOVA, and logistic regression were performed to analyze the data.Results: The prevalence of postpartum depression during the pandemic period was 31.82%. Factors contributing to postpartum depression were the mother’s age (p=0.011), childcare stress (p=0.001), stressful life events (p=0.003), and pregnancy status (p=0.0001). A logistic regression showed that pregnant status (Unplanned/unwanted pregnancy) was the most contributor to postpartum depression (β=0.377, t=5.138, p=0.0001).Conclusion: This study identified a high rate of postpartum depression with related factors, including mother’s age, childcare stress, life stress, and unplanned/ unwanted pregnancy. Screening for postpartum depression is required to ensure early detection among postpartum mothers.

HIV-infected women face several risk factors related to postpartum depression (PPD). We aimed to describe the prevalence and cumulative incidence of PPD in the low-income setting of Malawi and to determine the association between maternal and infant HIV and PPD. This longitudinal cohort study included 156 HIV-uninfected and 373 HIV-infected Malawian women enrolled 10-14 weeks after delivery who returned at 6, 9, 12, 15, and 18 months for follow-up visits. PPD was assessed at all visits. The prevalence of PPD at all visits was estimated using the Edinburgh Postnatal Depression Scale (EPDS). Association between PPD at 10-14 weeks and maternal and infant HIV status was assessed using log binomial regression. Cumulative incidence of PPD was assessed using Kaplan-Meier curves. Prevalence of PPD was highest (11%) at 10-14 weeks postpartum and decreased to 2.9% at 18 months. There was no association between maternal HIV status and PPD (prevalence ratio, 1.18; 95% confidence interval: 0.68 to 2.08). Among HIV-infected women, prevalence of PPD was higher among women whose infants had acquired HIV (prevalence ratio, 2.0; 95% confidence interval: 1.1 to 3.6). The cumulative probability of experiencing PPD over the first 12 months postpartum was estimated to be 33.5% for HIV-infected mothers with HIV-infected infants vs. 22.5% for HIV-infected mothers with uninfected infants and 23.2% for HIV-uninfected mothers. PPD prevalence did not differ between HIV-infected and -uninfected mothers but increased among women with an HIV-infected infant. Our findings suggest that it may be important to monitor PPD among women with HIV-infected infants.

Background: Postpartum depression (PPD) is a prevalent affective condition and a major public health concern. PPD can remain unidentified and influence the newborn's emotional and cognitive development, as well as the mother's health, relationships, and bonding with her newborn. Methods: A community-based cross-sectional study was conducted among 417 women who had given birth within 1 year. Participants were interviewed using a semi-structured questionnaire and the Edinburgh Postnatal Depression Scale. Sociodemographic variables were analyzed using descriptive statistics, and the bivariate chisquare test was used to investigate the factors associated with PPD. Results: The prevalence of PPD was 32%. There was a significant association between PPD and the sex of the child; birth weight of the child; psychological support from family, friends, and husband; marital conflicts; and history of depression. Conclusion: The prevalence of PPD in Alhasa city was higher than previously thought in some regions of Saudi Arabia, highlighting the essential need to detect pregnant women at high risk of developing PPD so that their risk can be reduced and appropriate interventions can be implemented to treat the condition. The caregivers for these mothers should be aware of the available strategies for reducing the occurrence and effects of PPD. Intervention strategies to prevent and decrease PPD occurrence should focus on finding women with female newborn, low birth weight children, marital disputes, and weak social support networks.

Prevalence of antenatal depression and postpartum depression among Chinese fathers: A systematic review and meta-analysis

Background: Postpartum depression (PPD) significantly affects the welfare of mothers, infants, families, and communities. Mothers in rural areas often face low incomes, poor social security, low education levels, and inadequate medical services. These specific cultural, social, and economic aspects have led to a worsening of PPD in rural areas. However, the current situation of PPD among women in rural areas of China is still insufficiently explored. Aim: This study aims to explore the prevalence and risk factors of PPD among women in low-income developing rural areas of China. Methods: A cross-sectional design was used in this study. Edinburgh Postnatal Depression Scale (EPDS) was applied to evaluate PPD symptoms. General demographic questionnaire, obstetrics-/pediatrics-related questionnaire, and psychosocial-related questionnaire were adopted. Abuse Assessment Screen (AAS) was utilized to assess experienced intimate partner violence during pregnancy and postpartum. Social Support Rating Scale (SSRS) was utilized to measure their levels of social support. Results: Of the 467 participants, the overall prevalence of PPD among women in rural areas of China was 16.5%, and the average EPDS score was 8.35 (SD = 4.50). PPD occurred most frequently at 7-9 months postpartum (33.8%). Six factors associated with PPD were whether the sex of the baby was in line with the family's expectations, monthly income of partners, social support, IPV during pregnancy and childbirth, and negative life events in the last 1 year, as well as physical and mental exhaustion from caring for a baby. Conclusions: This study sheds light on the prevalence and various risk factors associated with PPD among women residing in low-income developing rural areas of China. The findings highlighted the need for targeted interventions and support systems designed to address the specific socioeconomic and cultural difficulties encountered by rural mothers.

This study aimed to assess the prevalence and incidence of postpartum depression (PPD) and to identify risk factors in a community cohort of Israeli-born, as well as new and veteran immigrant women. A random sample of 288 registrants at a community clinic was assessed for depressive symptoms at 26 weeks' pregnancy using the Beck Depression Inventory (BDI) and at 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Information regarding risk factors was gathered through interviews and medical record abstracting. The prevalence of PPD was 22.6%. Two-thirds of the women had scored ‘depressed’ during pregnancy, and one-third (6.9%) were new incident cases. Immigrant status was the only significant demographic predictor of PPD identified by either univariate or multivariate analysis, with Russian new immigrants having over twice the risk for PPD as Israeli-born subjects. The rate of PPD in this Israeli cohort was comparable to that found in other countries. The finding that immigrant status was the most potent demographic predictor may support the role of stressful life events in the etiology of PPD. The use of the EPDS for PPD screening was found acceptable and feasible in the primary health setting.

Depressed Motherhood: Prevalence and Covariates of Maternal Postpartum Depression among Urban Mothers in India.

Background: Postpartum depression (PPD) is one of the most common mental disorder occurring during the postnatal period among women. Few studies examined prevalence and risk factors of PPD from rural and urban settings in Karnataka, India. This study aimed to assess the prevalence of postpartum depression and identify the associated risk factors for its among women from Taluka of Vijayanagar District. Materials and Methods: A cross-sectional study was conducted in a community setting in rural and urban areas of Karnataka. All postnatal women were screened through a door-to-door survey and recruited after obtaining informed consent. A semi-structured questionnaire was used to collect sociodemographic characteristics and family related variables. Edinburgh postnatal depression scale (EPDS) was used to screen for postpartum depression. Results: A total of 810 postpartum women were recruited into the study. The overall prevalence rate of PPD (Fig. 1) was 28.8 per cent (233 out of 810 mothers) when 810 mothers were screened for postpartum depression (95% CI = 11.33. 13.16). Multivariate analysis showed postpartum depression was associated with age, locality, occupation of the mother, general illness in the mother, poor financial status and pressure to have male babies. Conclusion: Prevalence of postpartum depression among women is high in rural and urban settings of Vijayanagar District, Karnataka. A multitude of factors ranging from sociodemographic, maternal, economic and family related factors confer a high risk for PPD. Comprehensive interventions are needed to address these risk factors of postpartum depression in women in the community.

Introduction: Postpartum depression and anxiety are critical maternal mental health issues, especially in low- and middle-income countries like Nigeria, where mental health services are limited. These conditions can harm both mothers and their children and are often undiagnosed and untreated. Regional data is needed to guide targeted interventions. Aim: The study aimed to determine the prevalence of postpartum depression and anxiety among mothers attending postnatal clinics in Enugu and Delta States, Nigeria. Methods: A descriptive cross-sectional study was conducted among 399 postpartum mothers at four healthcare facilities in Enugu and Delta States. Participants were selected through multistage sampling. Data were gathered using a semi-structured questionnaire that included the Edinburgh Postnatal Depression Scale (EPDS) and Generalised Anxiety Disorder-7 (GAD-7). SPSS version 26 was used for analysis, with chi-square tests applied to explore associations. Results: Postpartum depression was found in 34.6% of respondents, and anxiety in 31.1%. Depression was more prevalent among women aged 26–35, with low income, secondary education, unplanned pregnancies, poor support, or prior mental illness. Anxiety was linked to previous mental illness, poor marital support, and recent stress. Significant associations included education, income, and marital relationship with depression; and history of mental illness, emotional support, and stress with anxiety., Conclusion: There is a moderately high prevalence of postpartum depression and anxiety in the study areas. Integrating mental health screening and support into routine postnatal care, along with training for healthcare providers, is essential. Further longitudinal studies are recommended to inform long-term maternal mental health strategies in Nigeria.

Prophylactic use of ketamine reduces postpartum depression in Chinese women undergoing cesarean section✰

Postpartum depression (PPD) is a significant global public health concern affecting 17.7% and 18.7% of mothers globally and in Kenya respectively. The study aimed to assess the prevalence of postpartum depression and to explore its sociodemographic and obstetric determinants among mothers attending the postnatal and maternal and child health clinics at Eldoret West Maternity Hospital in Kenya. Unfortunately, postpartum depression and its determinants often go undiagnosed or untreated, leading to inadequate documentation of its impacts. A descriptive cross-sectional study design was employed, involving 257 women aged 18-49 years with infants aged 6-14 weeks postpartum. Participants were randomly selected using a simple random sampling method. Data was collected using a modified version of the Edinburgh Postnatal Depression Scale (EPDS) translated to Swahili. Descriptive analysis, Chi-squared analysis, and odds ratios were used to assess associations between sociodemographic factors, obstetric variables, and postpartum depression. The study found a prevalence of postpartum depression among participants to be 17.5%, with a higher likelihood of postpartum depression among mothers who were; older (aged 31-49 years) (68.9%), married (77.8%), with higher education levels (80%), lower income (82.2%), and those not formally employed (82.2%). Obstetric factors such as parity of greater than two (53.3%), unplanned pregnancy (53.3%) preference for male infants (62.2%) with having had unresolved issues (p-value < 0.01) in the past month and a parity of greater than two (p-value<0.05) were found to be significantly associated with higher odds of PPD. The prevalence of maternal postpartum depression among mothers 6-14 weeks postpartum at Eldoret West maternity Hospital, Uasin Gishu County was found to be 17.5%. Several sociodemographic and obstetric factors are linked and predispose women to PPD. Based on the conclusions, we recommend early intervention and support for young mothers, prenatal and postnatal complication screening, mental health education, and awareness.

Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys