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Meta-Analysis
. 2024 Jul 31;14(7):e076847.
doi: 10.1136/bmjopen-2023-076847.

Systematic review and meta-analysis of postpartum depression and its associated factors among women before and after the COVID-19 pandemic in Uganda

Amir Kabunga  1 , Raymond Tumwesigye  2 , Eustes Kigongo  2   3 , Marvin Musinguzi  2 , Walter Acup  3 , Anna Grace Auma  4
Affiliations
Meta-Analysis

Systematic review and meta-analysis of postpartum depression and its associated factors among women before and after the COVID-19 pandemic in Uganda

Amir Kabunga et al. BMJ Open. .

Abstract

Objective: This meta-analysis aimed to estimate the national prevalence of postpartum depression (PPD) in Uganda and identify predictors in both pre-COVID-19 and post-COVID-19 eras.

Design: Used a systematic review and meta-analysis methodology.

Data sources: Reviewed papers were sourced from Medline/PubMed, PsycINFO, CINAHL/EBSCOhost, Google Scholar, ScienceDirect and African Journals Online.

Eligibility criteria for selected studies: The review encompassed observational studies published on PPD in Uganda from 1 January 2000 to 30 November 2023.

Results: 11 studies (involving 7564 participants) published from 1 January 2000 to 30 November 2023 were reviewed. The pooled prevalence of PPD in Uganda was 29% (95% CI 21% to 37%, I2=98.32%). Subgroup analysis indicated a similar prevalence before (29%, 95% CI 20% to 39%) and during (28%, 95% CI 22% to 32%) the COVID-19 period. Special groups exhibited a higher prevalence (32%, 95% CI 16% to 47%) than general postpartum women (28%, 95% CI 19% to 37%). Factors associated with PPD included poor social support (OR 1.19, 95% CI 1.17 to 1.22, I2=96.8%), maternal illness (OR 1.22, 95% CI 1.19 to 1.26, I2=96.9%), poor socioeconomic status (OR 1.43, 95% CI 1.40 to 1.46, I2=99.5%) and undergoing caesarean section (OR 1.15, 95% CI 1.12 to 1.17, I2=80.6%). Surprisingly, there was a marginal decrease in PPD during the COVID-19 period. Subgroup analysis highlighted a higher prevalence among mothers with HIV.

Conclusion: This study underscores the significant prevalence of PPD in Uganda, with sociodemographic factors increasing risk. Despite a slight decrease during the COVID-19 period, the importance of prioritising maternal mental health is emphasised, considering sociodemographic factors and pandemic challenges, to improve maternal and child health outcomes and overall well-being.

Keywords: COVID-19; health services accessibility; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Study flow diagram.
Figure 2
Figure 2. The pooled prevalence of PPD among women in Uganda. REML, residual maximum likelihood technique.
Figure 3
Figure 3. Funnel plot.
Figure 4
Figure 4. Subgroup analysis for PPD among women in Uganda. REML, residual maximum likelihood technique.
Figure 5
Figure 5. Prevalence of PPD among mothers living with HIV compared to general postpartum women. REML, residual maximum likelihood technique.
Figure 6
Figure 6. Sensitivity analysis. REML, residual maximum likelihood technique.
See this image and copyright information in PMC

References

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