Risk Factors For Postpartum Depression Research Articles

Effects of anemia during the third trimester of pregnancy on postpartum depression and pregnancy outcomes in pregnant women older than 35 years: a retrospective cohort study.

There is no study on the impact of anemia on postpartum depression and outcomes in mothers older than 35 years, which makes the nursing of these pregnant women with anemia more difficult. We retrospectively collected the demographic and clinical characteristics of pregnant women older than 35 years at conception between August 2014 and December 2019. Hemoglobin less than 110 g/L was defined as anemia. Postpartum depression was assessed according to Edinburgh Postnatal Depression Scale. A subgroup analysis was performed by dividing anemia into mild anemia or moderate and severe anemia. All participants were followed up for at least 3 months postpartum and their pregnancy outcomes were recorded. The existence of postpartum depression was evaluated at 4 weeks postpartum. The risk factors of anemia during the third trimester of pregnancy and the impacts of anemia on postpartum depression and pregnancy outcomes were analyzed using multivariable logistic regression analysis. A total of 519 pregnant older than 35 years women were included in this study, including 281 without anemia and 238 with anemia. No significant difference was found in the incidence of postpartum depression between anemia and non-anemia groups (18.9% vs. 12.8%, P=0.057), while the anemia group had significantly higher incidence of preterm delivery, prolonged labor, and caesarean section. The subgroup analysis found that significantly pregnant women with older age in the moderate or severe anemia subgroup had postpartum depression than those in the mild anemia subgroup (23.2% vs. 12.5%, P=0.038). A higher rate of preterm delivery, prolonged labor, and caesarean section was recorded in the moderate or severe anemia subgroup (8.3% vs. 20.4%, P=0.012; 30.2% vs. 43.0%, P<0.001; 20.8% vs. 40.1%, P=0.002). Moderate or severe anemia, the presence of depression during the first trimester of pregnancy, unplanned pregnancy, and fewer parity were identified as risk factors of postpartum depression in pregnant women older than 35 years with anemia. Anemia has significant impacts on pregnancy outcomes in pregnant women older than 35 years. Furthermore, moderate and severe anemia will significantly increase the incidence of postpartum depression, which should be corrected at an early stage to minimize its negative effects.

Prevalence of Postpartum Depression, Associated Factors, Social Support, and Professional Assistance: A Cross-Sectional Study in Port Said, Egypt

INTRODUCTIONPostpartum depression is a mental illness that affects post-childbirth mothers. It is associated with psychological and social risk factors such as negative childhood experiences and pregnancy and childbirth problems. Postpartum depression has not been a focus of concern in Egypt. Therefore, this study aimed to identify the prevalence of postpartum depression, its associated factors, social support, and professional assistance in Port Said, Egypt.METHODOLOGYA random sampling strategy was used to select 540 women ten weeks postpartum. Data were collected using a questionnaire during an interview to identify potential risk factors for postpartum depression. The modified Arabic version of the Edinburgh Postpartum Depression Scale was used to assess symptoms of postpartum depression which is a multidimensional measure of social communication. Statistical analysis was completed using SPSS 25.0. software.RESULTSIt was found that 24.4% of women were at risk for postpartum depression. Social support from family and friends was significantly associated with mitigation of postpartum depression.CONCLUSIONThis study affirmed postpartum depression was a common health problem among 540 women who gave birth in Port Said, Egypt. Early detection and efficient screening methods to detect postpartum depression should be applied, especially in areas with a high risk for this condition. Early detection may prevent complications for mothers, babies, and families.

An exploratory study of vitamin D levels during pregnancy and its association with postpartum depression

High prevalence of suboptimal vitamin-D levels is observed in pregnant Australian women. Postpartum depression (PPD) is the most prevalent mood disorder associated with childbirth and it is suggested low vitamin-D is associated with depression. There is minimal research investigating antenatal screening of vitamin-D. Additionally, there is conflicting research on the link between vitamin-D levels during pregnancy and developing PPD. Aims were to investigate antenatal screening of vitamin-D and prevalence of suboptimal vitamin-D levels among pregnant women in rural Australia, and to explore the link between low levels of vitamin-D and PPD. A retrospective observational study was conducted at a rural general practice in Australia. The percentage of women screened and the levels of vitamin-D at time of screening was profiled. Additionally, the association between antenatal vitamin- D levels, risk factors for PPD and developing PPD were assessed. 57.1% of women were screened during the antenatal period for vitamin-D. 66.3% had serum vitamin-D below optimal levels (23.9% deficient; 42.4% suboptimal). Women with PPD had significantly lower levels of vitamin-D antenatally (p ​< ​0.01) compared to women without PPD. PPD was significantly negatively correlated with antenatal vitamin D levels (p ​< ​0.01). Doctors screened over half of women for vitamin-D in the antenatal period and the majority of pregnant women had below optimal levels of vitamin D. Low vitamin-D levels during pregnancy is associated with developing PPD. Future research should investigate effects vitamin-D supplementation may have on reducing incidence of PPD and other adverse pregnancy outcomes associated with low antenatal levels of vitamin-D. • In a rural Australian setting, GPs screened over half their patients for vitamin D in the antenatal period. • Most pregnant women had suboptimal levels of vitamin D. • Having lower levels of vitamin D during pregnancy was significantly correlated with developing PPD.

Relationship between perceived obstetric violence and the risk of postpartum depression: An observational study

ObjectiveTo determine the relationship between perceived obstetric violence and the risk of postpartum depression (PPD). DesignA cross-sectional observational study SettingDuring 2019 in Spain Participants782 women who had given birth in the preceding 12 months in Spain. MeasurementsOnline questionnaires were distributed to the women via their midwives and women's associations. The questionnaire included sociodemographic and clinical variables, and questions regarding the mothers' perception of obstetric violence globally and in its different forms: verbal, physical and psycho-affective. The response rate was 93.65%. Crude and adjusted odds ratios (OR and aOR, respectively) were estimated using binary logistic regression. Risk of PPD was estimated by the Edinburgh Postnatal Depression Scale (EPDS). FindingsThe mean EPDS score was 8.34 points (standard deviation: 3.80), with 25.4% (199) at risk of PPD (≥ 10 points). Risk factors for PPD included, multiparity (aOR: 1.62, 95% CI:1.10–2.39), newborn NICU admission (aOR: 1.93, 95% CI: 1.06–3.51), experiencing verbal obstetric violence (aOR: 2.02, 95% CI: 1.35–3.02), and psycho-affective obstetric violence (aOR: 2.65, 95% CI: 1.79–3.93). The perception of support during pregnancy, birth, and the puerperium was found to be a protective factor: aOR 0.15 (95% CI: 0.04–0.54) for women who perceived enough support and aOR 0.13 (95% CI: 0.0–0.45) for women who received much support Key ConclusionsOne in four women are at risk of PPD. Multiparous women, those whose newborn required NICU admission, those who lacked partner support, and those who experienced verbal or psycho-affective obstetric violence had a higher prevalence of PPD risk. FundingThe authors declare that this study was conducted without funding.

Prevalence and Risk Factors Associated with Postpartum Depression during the COVID-19 Pandemic: A Literature Review and Meta-Analysis.

Background: Owing to the high prevalence and detrimental consequences, postpartum depression (PPD) has been identified as one of the severe global public health issues in the last decade. Prior research found that during disasters or events, the prevalence rates of mental disorders among postpartum women are significantly high. However, the effect of the coronavirus disease 2019 (COVID-19) pandemic on PPD and its risk factors remained unclear for postpartum women. Therefore, the present systematic review and meta-analysis aimed to estimate the influence of the COVID-19 pandemic on the prevalence of PPD and to summarize risk factors for PPD during the COVID-19 pandemic. Methods: Three electronic databases of MEDLINE, EMBASE, and Cochrane library databases were systematically searched for articles from their commencements until 1 November 2021. Quality assessment of included studies, random-effects meta-analysis, and sensitivity analysis were performed. Results: A total of eight studies with 6480 postpartum women during the COVID-19 pandemic were included, and most studies were conducted in developed countries. The pooled prevalence of PPD was 34% (95% CI: 21–46%) during the COVID-19 pandemic, much higher than the incident of previous research during the non-pandemic period. Risk factors for PPD during the COVID-19 pandemic were defined as socio-demographic and clinical characteristics, stress and anxiety, lack of various supports, and the COVID-19 related factors. Conclusion: The research findings indicated that the COVID-19 pandemic could make detrimental effects on maternal mental wellbeing among women after childbirth. Investigating the prevalence and risk factors of PPD among postpartum women could shed some light on their mental and emotional states; so that support measures and tailored interventions from health professionals and policymakers could be offered to improve the maternal and infant outcomes, especially during the COVID-19 pandemic. Much more research on maternal psychological wellbeing during the COVID-19 pandemic was strongly recommended to undertake in the middle and low-income countries.

Prevalence and risk factors of postpartum depression in sub-Himalayan region

BackgroundPostpartum depression (PPD) is a common problem faced by women after childbirth. The adverse effects of PPD upon the maternal-infant relationship and child development reinforce the need for early identification and effective treatment models. This study intends to add to the existing knowledge about the prevalence of PPD and its associated risk factors in the hilly region in Himachal Pradesh. MethodsA hospital-based cross-sectional study was conducted on 426 women presenting for a postpartum visit at 6 weeks postpartum. Sociodemographic characteristics were recorded on a pretested questionnaire. Women were screened for postpartum depression using a validated EPDS (Edinburgh postnatal depression scale) prestructured questionnaire with 10 questions. Women were divided into two groups based on screening results. ResultsThe overall prevalence of PPD in the study was 17.4%. Out of sociodemographic factors, age (0.010) and family structure (0.008) were found to be significant. Nuclear family women were more prone to PPD. Domestic abuse (<0.001) is also a leading factor for PPD. By comparing obstetric and gender issues, it was found that the total number of previous living children (p-value <0.001), gender of previous living children (<0.001), and gender of newborns (<0.001) are the major determining factors of PPD. Another factor that was significantly related to PPD was an unwanted pregnancy. ConclusionsWe have found a high prevalence of PPD in our region that does not have screening protocols for the screening of such patients. We, therefore, propose routine screening for postpartum depression at 6 weeks postpartum.

Contribution of Premature Baby (the Low Birth Weigh) towards Postpartum Depressed Mother

Postpartum depression is a common phenomenon and has the complexities which bringing on adverse consequence for mother, baby, and family. The reference of this research provides an overview of the various risk factors for postpartum depression. This research is aimed to identify various risk factors such as level of depression, postpartum type, husband’s support, baby weight, parity and number of children. Those factors can be the cause of postpartum. Women with postpartum depression who have the baby in low weight can be identified as the strongly predictor factor of postpartum depression cause. The method applied in this research is an observational research with cross sectional design which involving 75 postpartum mothers who having live babies. Data analysis is conducted by chi-square that presents the correlation of baby in low weight and the incidence of depression indicated on p value less than 0,05. Data are collected at once time. Result shows that there is a correlation of childbirth type, social support, baby weight, and parity toward the incidence of postpartum depression. This research provides a crucial reference about mother with postpartum depression that can be caused by the birth of low baby weigh. For further researchers, it can be an insight for analysis as the effort of baby and mother care in case to prevent the postpartum depression.

Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies

Evidence on risk factors for postpartum depression (PPD) are fragmented and inconsistent. To assess the strength and credibility of evidence on risk factors of PPD, ranking them based on the umbrella review methodology. Databases were searched until 1 December 2020, for systematic reviews and meta-analyses of observational studies. Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria. Including 185 observational studies (n = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81-2.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70-2.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35-1.75). Following URC, the association was suggestive for Caesarean section (OR = 1.29, 95%CI 1.17-1.43), gestational diabetes (OR = 1.60, 95%CI 1.25-2.06) and 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57-0.86); and weak for preterm delivery (OR = 2.12, 95%CI 1.43-3.14), anaemia during pregnancy (OR = 1.47, 95%CI 1.17-1.84), vitamin D deficiency (OR = 3.67, 95%CI 1.72-7.85) and postpartum anaemia (OR = 1.75, 95%CI 1.18-2.60). No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as 'convincing evidence'. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and 'very low' for remaining factors. The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. These results should be integrated in clinical algorithms to assess the risk of PPD.

Perceived Social Support Partially Mediates the Impact of Temperament and Character on Postpartum Depression.

IntroductionTemperament and character of pregnant women, especially harm avoidance (HA) and self-directedness (SD) have been identified as risk factors for postpartum depression, in addition to poor social support. However, the relationship between these personality traits and social support for depressive symptoms after delivery has not been examined.MethodsData were extracted from a prospective cohort survey on pregnant women conducted in Nagoya, Japan that included the Temperament and Character Inventory (TCI), the Social Support Questionnaire (J-SSQ), and the Edinburgh Postnatal Depression Scale (EPDS) at approximately week 25 and 1 month postpartum. A mediation analysis using structural equation modeling (SEM) was used to test if social support in pregnancy is a mediator between personality traits and postpartum depressive symptoms.ResultsThousand five hundred and fifty-nine women were included in the analysis. Both harm avoidance and SD were significantly associated with depressive symptoms (total effect: β [SE], 0.298 [0.041], P < 0.001 for harm avoidance; total effect: β [SE], −0.265 [0.067], P < 0.001 for SD). Mediation analysis showed that the effect of harm avoidance on depressive symptoms was partially mediated by low social support (direct effect: β [SE], 0.193 [0.004], P < 0.001; indirect effect: β [SE], 0.082 [0.034], P = 0.015). Self-directedness on depressive symptoms was not found to be mediated by low social support.ConclusionResults indicate that poor social support worsens depressive symptoms in women with high HA during pregnancy. Limitations include a possible selection bias due to the limited target facilities; most variables being evaluated based on self-report questionnaires, and different number of samples available for analysis between harm avoidance and SD.

Are Experiences of Racial Discrimination Associated with Postpartum Depressive Symptoms? A Multistate Analysis of Pregnancy Risk Assessment Monitoring System Data.

Background: Postpartum depression (PPD) is a serious public health crisis disproportionately affecting women of color. We examine whether interpersonal racial discrimination is associated with higher odds of postpartum depressive symptoms (PPDS) among women of color and how it may vary by race/ethnicity and maternal educational attainment. Materials and Methods: We present a secondary analysis of cross-sectional data from Pregnancy Risk Assessment Monitoring System (PRAMS) postnatal surveys conducted in nine jurisdictions between 2012 and 2015 that included a question about being upset by experiences of racial discrimination within 12 months before giving birth. Results: Being upset by racial discrimination was associated with nearly three times higher odds of PPDS. Among women of color with at least some college education, the higher odds of PPDS associated with racial discrimination were greater than threefold, and for women with less than a high school education were less than twofold. Conclusion: Addressing risk factors for PPD, including racial discrimination, may inform strategies to reduce racial disparities in maternal mental health.

Does Cesarean Section Increase the Risk of Postpartum Depression? A Systematic Literature Review

Background: Postpartum depression (PPD) is a psychological disorder experienced by mothers at 4 weeks to 6 months postpartum. One of the risk factors for postpartum depression is the type of delivery. The mode of delivery in its effect on postpartum depression has been studied extensively with conflicting results whether vaginal delivery or cesarean section (CS) that can affect postpartum depression (Rauh et al., 2012). Methods: This is a systematic literature review with a research question using PICO standard namely "What is the correlation between mode of delivery and postpartum depression?". 325 literature were obtained from five different databases. The screening was carried out according to PRISMA flowchart and bringing in a total of 21 literature to be reviewed. Results: Most of the literature reported that mothers with CS have higher EPDS scores than mothers with vaginal delivery. One literature stated that mothers with CS were more protected and less prone to PPD, and other studies stated that the method of delivery was not associated with PPD. Conclusion: Delivery mode is associated with postpartum depression in most studies. Mothers with CS are more at risk of exposure to PPD than mothers with vaginal delivery

Risk Factors for Postpartum Depression During COVID-19

Many social problems have been highlighted by COVID-19. The perinatal mental health of pregnant women is closely related to the newborn's health and the stability and harmony of family. However, there are few studies on postpartum depression in China. In this study, single-factor analysis and multivariate logistics regression analysis will be used to explore the high-risk factors of postpartum depression in COVID-19.From October 2020 to February 2021, the basic information of 388 puerperas from two cities in central and Northwest China, Xinxiang and Xi'an, were collected, including occupation, age, education, religious belief, nationality, partner companion time during pregnancy, major life-influenced events in the past six months, cognition of COVID-19, and gender and health of the newborn. Edinburgh Postpartum Depression Scale (EPDS) was used for psychological evaluation. SPSS 13.0 was used for univariate and multivariate logistic regression analysis. According to the Edinburgh Depression Scale, 45 cases were classified into the depression group (score 13), and 343 cases were classified into the normal group (score &lt; 13).The statistical results of general and clinical data showed that there was no significant correlation between occupation, nationality, weekly accompanying time, or age and postpartum depression (P &gt; 0.05). In logistic multivariate regression analysis, the risk of postpartum depression in pregnant women with neonatal diseases was about 2.23 times higher than that of healthy pregnant women (OR = 2.233). When pregnant women believed that COVID-19 had a negative impact on the health of their newborns, their risk of postpartum depression was 3.31 times higher than that of perinatal women who did not(OR=3.314). This study explored the risk factors of postpartum depression in COVID-19, hoping to provide a method for prevention and treatment.

Incidence and Risk Factors for Postpartum Depression Among Women with Early Severe Preeclampsia

Patients admitted with severe preeclampsia before 34 weeks (early sPREX) have multiple known risk factors for postpartum depression (PPD) including preterm delivery, low birthweight infants, and a stressful life event. Minimal data exist characterizing the development of PPD in patients with early sPREX. We aim to evaluate the incidence and identify risk factors of PPD in this population.

A secondary analysis investigating Pre-Eclampsia, health outcomes and demographics as risk factors of postpartum depression

To determine if, based on results from international studies, pre-eclampsia is a significant risk factor for postpartum depression in the US. Also, to examine health and demographic variables and their association with postpartum depression to assist in determining additive impact.

Emergent cesarean delivery and immediate postpartum depression symptoms and social work consultation rates

Birth trauma, which may result following emergent cesarean delivery (CD), is a risk factor for postpartum depression (PPD). We hypothesized that PPD symptoms and social work (SW) consultation rates would be higher in emergent term CDs compared to vaginal deliveries (VD).

Prevalence and associated psychological risk factors of postpartum depression: a cross-sectional study

This cross-sectional study aimed to evaluate the prevalence of postpartum depression and the associated risk factors in a sample of Italian women at three months after delivery. Eighty women were screened by completing the Edinburgh Postnatal Depression Scale (EPDS). Women with a score ≥10 were evaluated as positive and other variables were detected through the administration of the Postpartum Depression Predictors Inventory. The prevalence of postpartum depression in the sample was 11.25% (EPDS score >10). A statistically significant relationship was found between the predisposition to postnatal depression and various risk factors such as prenatal depression, stressful life experiences marital problems. Furthermore, strong emotional and instrumental support from the partner and a good economic status can represent protective factors. It is essential to promote an integrated approach to postpartum affective disorders in which psychosocial risk factors are taken into account, and adequate screening programs are implemented. Impact Statement What is already known on this subject? Pregnancy can cause emotional stress for women with consequent development, in some cases, of mood disorders such as postpartum depression. What do the results of this study add? According to this study, women suffering from postpartum depression showed a significant tendency to anxiety and depression, low perceived support from the partner, and low socio-economic status. What are the implications of these findings for clinical practice and/or further research? It would be desirable to promote an integrated approach to postpartum affective disorders in which psychosocial risk factors are taken into account and adequate screening programs are implemented.

Incidence and Risk Factors for Postpartum Depression among Women with Preterm Prelabor Rupture of Membranes.

Patients admitted for preterm prelabor rupture of membranes are more likely to have risk factors for postpartum depression, including preterm delivery, low-birthweight infants, and a stressful life event. However, there is a paucity of data characterizing the development of postpartum depression in this population. We aim to evaluate the incidence of and describe risk factors for postpartum depression among patients admitted with preterm prelabor rupture of membranes. This is a retrospective cohort study of patients admitted for preterm prelabor rupture of membranes in a single health system between 2013 and 2019. Patients who developed depression were compared with patients who did not develop depression. Demographic, antepartum/intrapartum/postpartum, and neonatal characteristics were compared. Bivariate statistics were used to compare outcomes and logistic regression was used to estimate adjusted odds ratios. Of 132 included patients with preterm prelabor rupture of membranes, 25 (18.9%) had postpartum depression. Factors significantly (p < 0.05) associated with postpartum depression included history of depression, anxiety, or any prior mental health condition. Earlier admission gestational age, rupture of membranes < 28 weeks, earlier delivery gestational age, neonatal morbidity, and neonatal necrotizing enterocolitis also were significantly associated with postpartum depression. Latency, maternal postpartum length of stay, and neonatal intensive care unit length of stay were not significantly associated. In regression models, only a history of depression (odds ratio [OR], 11.89; 95% confidence interval [CI], 2.78-50.95) and neonatal morbidity (OR, 5.01; 95% CI, 1.15-21.89) remained associated with postpartum depression. Postpartum depression occurred in nearly one in five patients with preterm prelabor rupture of membranes. Pre-existing depression and adverse neonatal outcomes strongly predicted postpartum depression. There is an urgent need to prioritize maternal mental health among patients with preterm prelabor rupture of membranes in the peripartum period. Further research is needed to identify optimal resources for mitigating the risk of postpartum depression in this cohort. · After PPROM, postpartum depression is common.. · Maternal depression and neonatal morbidity are risk factors for PPD.. · Hospital admission permits intervention for PPD..

Associations between postpartum depression and assistance with household tasks and childcare during the COVID-19 pandemic: evidence from American mothers

BackgroundThe early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores.MethodsThis study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 – November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey.ResultsParticipants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05).ConclusionsThe maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic.

Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis.

The current systematic review aimed to present the pooled estimated prevalence and risk factors of PPD. Postpartum depression seriously affects the physical and mental health of the mother and child. However, high-quality meta-analysis is limited, which restricts the screening and intervention of postpartum depression. A systematic review and meta-analysis. Cochrane Library, PubMed, Embase and Web of Science were searched for cohort and case-control studies investigating the prevalence and risk factors of postpartum depression from inception to December 31st, 2020. Meta-analyses were performed to identify postpartum depression prevalence and risk factors using a random-effects model. Of the 33 citations evaluated, 27 reported the prevalence of postpartum depression in 33separate study populations containing 133,313. Pooled prevalence in all studies was 14.0% (95%CI, 12.0%-15.0%). The prevalence varied according to country (from 5.0% to 26.32%) and developing countries, especially China, have a high prevalence of postpartum depression. The following risk factors were associated with postpartum depression: gestational diabetes mellitus(OR=2.71, 95%CI 1.78-4.14, I2 =0.0%), depression during pregnancy(OR=2.40, 95%CI 1.96-2.93, I2 =96.7%), pregnant women give birth to boys(OR=1.62; 95%CI 1.28-2.05; I2 =0.0%), history of depression during pregnancy(OR=4.82, 95%CI 1.32-17.54, I2 =74.9%), history of depression(OR=3.09, 95%CI 1.62-5.93, I2 =86.5%) and epidural anaesthesia during delivery(OR=.81, 95%CI .13-4.87, I2 =90.1%). The prevalence of postpartum depression seems to be high, especially in developing countries. Gestational diabetes mellitus, depression during pregnancy, pregnant women give birth to boys, history of depression during pregnancy, history of depression, epidural anaesthesia during delivery were identified as risk factors for postpartum depression. Understanding the risk factors of PPD can provide the healthcare personnel with the theoretical basis for the patients' management and treatment. This systematic review and meta-analysis identified six significant risk factors for PPD, which provides nurses with a theoretical basis for managing and treating women with PPD to effectively improve the screening rate, intervention rate and referral rate of women with PPD.

Regional Differences in Various Risk Factors for Postpartum Depression: Applying Mixed Models to the PRAMS Dataset.

Purpose: The purpose of this study was to assess the association between various risk factors with postpartum depression severity using a large dataset that included variables such as previous mental health status, social factors, societal factors, health care access, and other state-wide or region-specific variables.Methods: We obtained the most recently available (2016–2017) dataset from the Pregnancy Risk Assessment Monitoring System (PRAMS), which is a dataset compiled by the Centers for Disease Control (CDC) that collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy from over 73,000 women in 39 states. We utilized a hierarchical linear model to analyze the data across various levels, with a symptom severity scale (0–8) as the dependent variable.Results: Of the 21 variables included in the final model, nine variables were statistically significant predictors of symptom severity. Statistically significant predictors of increased postpartum depression symptom severity included previous depression diagnosis and depression symptoms during pregnancy, baby not residing with mother, unintentional pregnancy, women with less than a high school degree and more than a college degree, Women Infants Children (WIC) enrollment, and married women. In contrast to these other factors, attendance at a postpartum follow up appointment was associated with significantly increased symptom severity. Age revealed an inverted curve in predicting postpartum symptom severity.Conclusions: There was no significant difference in symptom severity scores across the 39 participating states. Most notably, postpartum depression symptom severity was associated with previous depression diagnosis and previous symptom severity, but our results also reveal novel social and education factors that contribute to the support and well-being of the mother and child.