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

Abstract

Aim: The current systematic review aimed to present the pooled estimated prevalence and risk factors of PPD.

Background: 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.

Design: A systematic review and meta-analysis.

Methods: 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.

Results: Of the 33 citations evaluated, 27 reported the prevalence of postpartum depression in 33 separate study populations containing 133,313.

Subjects: 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%).

Conclusions: 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.

Implications for practice: 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.