In this month’s research spotlight, we highlight 5 review studies that focus on the prevalence of maternal mental disorders, conducted between 2012 and 2021.
1. Prevalence and determinants of common perinatal mental disorders in women in low- and middle-income countries: A systematic review (2012)
This systematic review and meta-analysis was aimed at summarising the evidence surrounding the nature, prevalence and determinants of non-psychotic common perinatal mental disorders among women living in LMICs. Forty seven (47) studies were included in the review, 13 of which reported point prevalence of mental disorders in pregnant women, and 34 of which analysed women during the first year after giving birth. The study found that the prevalence of mental health disorders among the women was on average 15.9 percent during pregnancy, and 19.8 percent during the postpartum period. The study also identified several risk factors for perinatal mental health disorders which can be categorised into socio-economic, relationship with intimate partners, family and social relationships, reproductive and general health, history of mental health problems, and infant characteristics.
2. Magnitude and risk factors for postpartum symptoms: A literature review (2015)
The aim of this review was to summarise and synthesise the current magnitude of postpartum depression based on both self-reported questionnaires and clinical interviews and as well as identify the associated factors contributing to postpartum depression in both developed and developing countries. The review included a total of 202 studies out of which 191 were based on self-reported questionnaires conducted in 42 countries, and 21 studies were based on clinical interviews conducted in 15 countries. The study found that the prevalence of postpartum depression by self-reported questionnaires ranged from 1.9 – 82.1 percent in developed countries, and 5.2 – 74.0 percent in developing countries. However, when based on clinical interviews and tools such as the Edinburgh Postnatal Depression Scale (EPDS), the prevalence was higher in developing countries than in developed countries. Prevalence also varied with the timeframe (that is at less than 4 weeks, 4-8 weeks, 6 months and at 12 months after giving birth). The study also categorised risk factors for postpartum depression into physical and biological factors, psychological factors, obstetric and paediatric factors, socio-demographic factors, and cultural factors.
3. Epidemiology of maternal depression, risk factors and child outcomes (2016)
This systematic review and meta-analysis aimed at identifying important knowledge gaps in the prevalence and risk factors of perinatal depression as well as the association of perinatal depression with infant and childhood outcomes among women in low- and middle-income countries. A total of 25 studies were included in the review, 5 of which focused on depression during pregnancy and 20 focused on depression after giving birth. The pooled prevalence of antepartum depression (depression during pregnancy) was estimated at 25.3 percent, while the pooled prevalence of postpartum depression was estimated at 19.0 percent, implying that depression during pregnancy was higher than during the postpartum period. The review identified risk factors for perinatal depression included early life abuse, adult abuse, low socioeconomic status during pregnancy, lack of social support, a history of mental illness, and gender preference. Infant and childhood outcomes of perinatal depression were found to include: infant weight, prematurity and child growth challenges, higher bouts of childhood illnesses, and poor child neuro-developmental and behavioural outcomes.
4. The magnitude of postpartum depression among mothers in Africa: A literature review (2020)
The aim of this review was to summarise and synthesise the current magnitude of postpartum depression (PPD) among mothers in Africa based on different assessment tools. The review included 21 studies, of which 15 used the Edinburgh Postnatal Depression Scale (EPDS), 6 used other assessment tools, and 4 used the EPDS validated in the African local languages and cultures. The study found wide variations in PPD from country to country: Morocco (6.9 – 14 percent), Sudan (9.2 percent), Tanzania (12 percent), Kenya (13 – 18.7 percent), Nigeria (10.7 – 22.9 percent), Zimbabwe (33 percent), South Africa (31.7 – 39.6 percent), and Uganda (43 percent). In addition to variation among countries, there were variations among regions as well as socioeconomic settings. The review also found that the time frame used in studies for assessing PPD may have implications on the prevalence rates obtained hence there is need to consistently take into consideration a uniform time frame while evaluating PPD. Overall, PPD prevalence among African mothers was found to be higher than in developed countries.
5. Mapping global prevalence of depression among postpartum women (2021)
The aim of this systematic review and meta-analysis was to present an updated global estimate of postpartum depression (PPD) epidemiology, synthesise risk factors, and provide evidence-based data for prioritisation of maternal mental health treatment. The study included a total of 565 studies involving 1,236,365 women across the globe. The study found that PPD prevalence varied significantly from country to country and from region to region. Denmark had the lowest PPD prevalence at 6.48 percent, while Afghanistan had the highest PPD prevalence at 60.93 percent. Countries with high incomes also had lower PPD prevalence as compared to low- and middle-income countries. Additionally, prevalence rate varied based on the assessment/diagnostic tools used. Risk factors for PPD identified include: marital status, educational level, social support from family and friends, support from partner, violence, gestational age, breastfeeding, infant death, unplanned pregnancy, financial challenges, life stress, smoking and alcohol use, and living conditions.
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