Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis

Dadi, Abel Fekadu; Akalu, Temesgen Yihunie; Baraki, Adhanom Gebreegziabher; Wolde, Haileab Fekadu

doi:10.1371/journal.pone.0231940

Cited by 67 publications

(86 citation statements)

References 91 publications

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“…The ndings of this study suggest that rates of antenatal depressive symptoms are high in Rwanda with more than one in four pregnant women in this study having scores in the depressive range. This study reveals a high prevalence of antenatal depressive symptoms compared to other African countries such as Malawi (19%) [1], Ethiopia (16%) [24] but similar to the ndings of a previous assessment of the pooled prevalence of antenatal depression in Africa overall (26.3%) in a recent 2020 systematic review [5]. A previous community-based study in Rwanda using same EPDS cut-off [18], however that showed lower prevalence.…”

Section: Discussionsupporting

confidence: 86%

“…Hence, there is growing evidence that antenatal depression not only affects pregnancy and neonatal outcomes, but also leads to postnatal depression and has in uence on offspring's cognitive development, emotions and behaviors in childhood [4]. However, despite its adverse effects on maternal and child health, less known about the magnitude and risk factors of maternal depression during pregnancy in developing countries [5], and antenatal depression is often overlooked in routine screening [6].…”

Section: Introductionmentioning

confidence: 99%

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Antenatal Depressive Symptoms in Rwanda: Rates, Predictors, and Social Support

Gishoma

Hynie

et al. 2021

Preprint

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BackgroundPrevalence of perinatal depression is high in Rwanda and has been found to be associated with the quality of relationship with partners. This study extends this work to examine the relationship between antenatal depressive symptoms and social support across several relationships among women attending antenatal care services. Methods Structured survey interviews were conducted with 396 women attending antenatal care services in 4 health centers in the Southern Province of Rwanda. The Edinburgh Postnatal Depression Scale (EPDS) and Maternity Social Support Scale (MSSS) were used to assess antenatal depressive symptoms and the level of support respectively. Socio-demographic and gestational information, pregnancy intentions, perceived general health status, and experience of violence were also collected. Univariate, bivariate analyses and a multivariate logistic regression model were performed to determine the relationship between social support and predictors of antenatal depressive symptoms. ResultsMore than half of respondents were married (55.1%) or living with a partner in a common-law relationship (28.5%). About a third (35.9%) were in their 6th month of pregnancy; the rest were in their third term. The prevalence of antenatal depressive symptoms was 26.6% (EPDS ≥ 12). Bivariate analyses suggested that partner and peer support negatively predict depression level symptoms.Adjusting for confounding variables such as unwanted pregnancy (AOR: 0.415, CI: 0.221- 0.778), parity (AOR): 0.336, C.I: 0.113–1.000) and exposure to extremely stressful life events (Odds Ratio = 2.300, C.I. = 1.263–4.189), husband/partner support (AOR: 4.458, CI: 1.833- 10.842) was strongly significantly associated with antenatal depressive symptoms such that women reporting good support were less likely to report depression level symptoms than those reporting poor support or those with no partner. Peer support was no longer significant.Conclusion The study revealed that social support may be a strong protector against antenatal depressive symptoms but only support from the partner. This suggests that strengthening support to pregnant women may be a successful strategy for reducing the incidence or severity of maternal mental health problems, but more work is required to assess whether support from peers can compensate for absent or unsupportive partners.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Antenatal Depressive Symptoms in Rwanda: Rates, Predictors, and Social Support

Gishoma

Hynie

et al. 2021

Preprint

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“…All of the studies conducted in South Africa, Malawi and Ethiopia identified a high prevalence of postpartum depression (34, 26 and 33%, respectively) but failed to identify the effect of postpartum depression on exclusive breast feeding practices [ 24 , 25 , 60 ]. Whereas, in this review the prevalence of postpartum depression in Sub Saharan Africa was 18.9% this finding was higher than a review conducted in Africa [ 61 ]. The prevalence of postpartum depression varies in sub regions of Sub Saharan Africa, which was 20.2% in western Africa, 18.6% in Eastern Africa and 18.3% in southern Africa.…”

Section: Discussioncontrasting

confidence: 81%

Effect of postpartum depression on exclusive breast-feeding practices in sub-Saharan Africa countries: a systematic review and meta-analysis

Woldeyohannes¹,

Tekalegn

Sahiledengle

et al. 2021

BMC Pregnancy Childbirth

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Background Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries. Methods PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Result A total of 1482 published articles and gray literatures were retrieved from different databases. Additional articles were identified from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30,021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). Conclusion In Sub Saharan Africa, the prevalence of postpartum depression was lower than the report of World Health Organization for developing Country in 2020. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.

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“…5,19 Our study showed that there is increased incidence of postpartum depression in upper lower class (46%) when compared to upper middle class (32%), and this study was supported by study conducted by Abel Fekadu et al, showed that low socioeconomic status was the significant contributing factor for development of postpartum depression. 16 Our study did not show any association between the literacy rate and risk of developing PPD, However, the other study conducted by Shafi et al, showed that there is decreased rate of PPD among graduates and among post graduates and it could be because of their self-esteem and better interpersonal relationship. Women from urban area are having more independent life and better life style choices, could act as a protective factor from mood disturbances during pregnancy.…”

Section: Discussioncontrasting

confidence: 78%

Prevalence and risk factor analysis for postpartum depression: a cross sectional study at tertiary care center, Mangalore

Kamath

Ajila

Shashirekha

2021

Int J Reprod Contracept Obstet Gynecol

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Background: The overall pooled estimate of the prevalence of Postpartum depression in Indian mothers is 22%. In India, women who deliver at a health facility often stays less than 48hrs after delivery and this leaves little opportunity for health personnel to counsel the mother and family members on the signs and symptoms of Postpartum depression (PPD) and when to seek care. So, it is important to screen the postpartum woman for depression. Edinburgh Postnatal Depression Scale is used as an effective tool to assess the level of postnatal depression. The objective of the study was to assess the prevalence and risk factors associated with postpartum depression in the postnatal mothers using EDPS scale.Methods: This study was conducted at A. J. Institute of Medical Sciences and Research Center from January 2019 to May 2020. A total of 950 postnatal mothers were interviewed using Edinburgh Postnatal Depression Scale.Results: A total of 950 cases were studied. Prevalence of Postpartum depression was 15.78%. Increased incidence was seen in the primigravida (12.2%) compared to multigravidas (3.57%). This study showed 1.89% mothers belonging to upper middle class, 5.05% belonging to lower middle class had PPD and 7.26% belonging to upper lower class and 1.57 % patients belonging to lower class had PPD. In our study, 9.26% patients who underwent normal vaginal delivery had PPD and 6.52% of patients who underwent lower segment caesarean section had PPD. In the present study, it was found that 1.05% mothers having IUD babies and 5.2% (96/950) mothers who required NICU admission developed PPD.Conclusions: In this study, the prevalence of postpartum depression was 15.78%. Risk of PPD is more with primigravida, belonging to lower middle class status, mothers who had NVD and mothers of IUD babies. Postpartum depression screening should be an integral part of postnatal care using EPDS scale. A multidisciplinary approach including obstetrician and psychiatrists and counsellor can jointly take care of the depressed mothers. Early screening of the women may reduce the adverse outcomes among both mother and child. Proper counselling should be done to all the pregnant women and the family members for the birth preparedness.

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Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis

Cited by 67 publications

References 91 publications

Antenatal Depressive Symptoms in Rwanda: Rates, Predictors, and Social Support

Antenatal Depressive Symptoms in Rwanda: Rates, Predictors, and Social Support

Effect of postpartum depression on exclusive breast-feeding practices in sub-Saharan Africa countries: a systematic review and meta-analysis

Prevalence and risk factor analysis for postpartum depression: a cross sectional study at tertiary care center, Mangalore

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