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. 2022 May 18;12(5):e051426.
doi: 10.1136/bmjopen-2021-051426.

Landscaping the evidence of intimate partner violence and postpartum depression: a systematic review

Lea Bo Sønderlund Ankerstjerne  1   2 , Sweetness Naftal Laizer  3 , Karen Andreasen  4 , Anne Katrine Normann  5 , Chunsen Wu  6   7 , Ditte Søndergaard Linde  2   7 , Vibeke Rasch  2   8
Affiliations

Landscaping the evidence of intimate partner violence and postpartum depression: a systematic review

Lea Bo Sønderlund Ankerstjerne et al. BMJ Open. .

Abstract

Objective: To assess the evidence of the association between exposure to intimate partner violence (IPV) and postpartum depression. IPV during pregnancy can have immediate and long-term physical and mental health consequences for the family. Therefore, it has been hypothesised that IPV may affect the risk of developing postpartum depression.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Global Health Library, Scopus and Google scholar were searched for published studies without restrictions on language, time or study design (up to May 2020). Studies were included if they assessed postpartum depression using the Edinburg Postnatal Depression Scale (cut-off≥10), among women who had been exposed to IPV (emotional, physical and/or sexual abuse). The quality of studies was judged according to the Newcastle-Ottawa scale.

Results: A total of 33 studies were included in the review (participants n=131 131). The majority of studies found an association between exposure to IPV and the development of signs of postpartum depression. Overall, studies measured both exposure and outcome in various ways and controlled for a vast number of different confounders. Thirty percent of the studies were set in low-income and lower-middle-income countries while the rest were set in upper-middle-income and high-income countries and the association did not differ across settings. Among the studies reporting adjusted OR (aOR) (n=26), the significant aOR ranged between 1.18 and 6.87 (95% CI 1.12 to 11.78). The majority of the studies were judged as 'good quality' (n=20/33).

Conclusion: We found evidence of an association between exposure to IPV and the development of signs of postpartum depression. Meta-analysis or individual patient data meta-analysis is required to quantify the magnitude of the association between IPV and postpartum depression.

Prospero registration number: CRD42020209435.

Keywords: Depression & mood disorders; MENTAL HEALTH; Maternal medicine; Reproductive medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of study selection in the review of intimate partner violence and postpartum depression.
Figure 2
Figure 2
Quality assessment of cohort studies according to country economic status and stars awarded for each item of the Newcastle-Ottawa Scale.
Figure 3
Figure 3
Results of IPV and the association with PPD from the studies set in HMIC, presented in a forest plot ordered according to descending quality. IPV, intimate partner violence; HMIC, high and upper-middle-income countries; PPD, postpartum depression.
Figure 4
Figure 4
Results of IPV and the association with PPD from the studies set in LMIC, presented in a forest plot ordered according to descending quality. aOR, adjusted OR; IPV, intimate partner violence; LMIC, lower-middle-income country.
See this image and copyright information in PMC

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