Barriers to mental health in post-partum women in India: A systematic review and meta-analysis

Abstract

Objectives: This study uses an exhaustive meta-analysis of descriptive epidemiological studies to determine the prevalence of major depression in post-partum women and its associated risk factors, across all ages in India.

Data sources: Using the PRISMA criteria as a guide, we searched databases such as PubMed, Scopus, Web of Science, and Embase to locate research articles released between 2020 and 2024. This study was registered by the International Prospective Register of Systematic Reviews PROSPERO (CRD42024513914).

Study selection: The eligible studies included all the English-language observational full-text articles reporting the percentage or frequency of the prevalence of depression in perinatal women in India.

Data extraction and synthesis: Pooled prevalence with a 95 % confidence interval was calculated using version 4.3.0 of the R software to conduct the meta-analysis, and the JBI score was used to evaluate the quality. A pooled odds ratio with a 95 % confidence interval was used to find out the association of risk factors with postpartum depression. We assessed heterogeneity with the Q and I² statistics. Egger's regression test and a funnel plot were used to evaluate publication bias.

Results: Utilizing a random effects model, the results of 59 publications were used to estimate the prevalence of post-partum depression in India from 2020 to 2024 to be 19 % (CI = 95: 15-23 %). Meta-regression analysis found that older age post-partum women had a higher prevalence of post-partum depression as compared to younger ones. Heterogeneity for prevalence was found to be 97 %. The sub-group analysis found a higher prevalence of post-partum depression in Southern India (22 %; 95 % CI: 15-31), studies conducted in community settings (19 %; 95 % CI: 12-28), urban areas (19 %; 95 % CI: 15-24), studies using study instruments other than EPDS scale (22 %; 95%CI: 11-39), and publication year 2024 (25 %; 95 % CI: 17-36).

Conclusion: Effective measures need to be taken to control all the risk factors found in this study to control post-partum depression in India.

Keywords: Cohort; Cross-sectional; Depression; Pregnancy; Prevalence.