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Meta-Analysis
. 2025 Apr;34(2):e70018.
doi: 10.1111/inm.70018.

Postnatal Depression Beyond 12 Months: A Systematic Review and Meta-Analysis

Elsie Hellyer  1 , Katrina Nash  2 , Ellie Jones  3 , Alice Sitch  4 , Jelena Jankovic  5 , Giles Berrisford  5 , Amelia Casey  3 , Christine MacArthur  3
Affiliations
Meta-Analysis

Postnatal Depression Beyond 12 Months: A Systematic Review and Meta-Analysis

Elsie Hellyer et al. Int J Ment Health Nurs. 2025 Apr.

Abstract

Traditionally, postnatal depression (PND) has been considered as depression in the first year after giving birth, although it has been argued that the 12-month cut-off may be somewhat arbitrary. Specialist perinatal mental health services in England have recently been extended to include women in their second year postpartum; however, there is no good estimate for the prevalence of PND beyond the first year. This review aimed to obtain the best estimate of the prevalence of PND in the second postpartum year. Eligible studies were those that assessed PND and provided a point prevalence using a validated screening tool or clinical diagnosis at least once beyond the first 12 months in women over the age of 18 years in any country. Studies were excluded if they only included women who were already depressed or had elevated depression scores at baseline. PubMed, Embase, Web of Science, CINAHL and PsychINFO were searched in January 2021 (and updated in February 2024) for studies that included the prevalence of PND beyond the first 12 postnatal months. Study quality was assessed using Cochrane's ROBINS-I and Risk of Bias 2 tools. Prevalence data were combined in meta-analysis using prediction intervals (PIs). A total of 6340 papers were found, and of these, 32 studies including 57210 participants across 18 countries met the inclusion criteria and were meta-analysed. The prevalence of PND in the second year (13-24 months) was 15% (95% confidence interval [CI] 12%, 17%; 95% PI 4%, 30%) and similar to that in the first year, 16% (95% CI 14%, 19%; 95% PI 6%, 31%). Despite considerable heterogeneity, common in meta-analysis of prevalence studies, findings show that a similar proportion of women experience PND in the second year after birth.

Keywords: postnatal care; postnatal depression; prevalence; systematic review.

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Conflict of interest statement

All authors have completed the Unified Competing Interest form: C.M. and E.J. declare National Institute for Health research (NIHR) funding to University of Birmingham for various research projects, J.J. and G.B. declare NIHR funding to QMUL for the PAAM study, J.J. is academic secretary in the Royal College of Psychiatrists and G.B. was previous vice chair and now elected member of the Faculty of Perinatal Psychiatry at the Royal College of Psychiatrists and National Speciality for Perinatal Psychiatry with NHS England.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Meta‐analysis of pooled prevalence in the first year (0–12 months), second year (13–24 months) and after this (> 24 months) postpartum.
See this image and copyright information in PMC

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