Nutritional factors and cross-national postpartum depression prevalence: an updated meta-analysis and meta-regression of 412 studies from 46 countries

Abstract

BackgroundPostpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression.MethodsTo estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016–2021 and combined our findings with a previous meta-analysis of articles published between 1985–2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables.Results412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010–0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016–0.242).ConclusionThe global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.

The Mental Health Literacy Status of Pregnant Women in Eastern Iran Regarding Postpartum Depression and its Associated Factors

“…Chile, South Africa, and Hong Kong have the highest rates of postpartum depression, with prevalence rates of 38%, 37%, and 30%, respectively. 6 In our country, the prevalence of postpartum depression has been estimated to be 13-22% at 6-8 weeks postpartum. 7 Not only does postpartum depression have immediate adverse effects on the mother, baby, and her family, but it can also lead to long-term complications such as chronic or recurrent depression.…”

Treatment gap and barriers to access mental healthcare among women with postpartum depression symptoms in Pakistan

“…The global prevalence of PPD is 17.2% ( Fish-Williamson & Hahn-Holbrook, 2023 ). As with major depression, suicide associated with PPD has become the second leading cause of death among women ( Lindahl, Pearson & Colpe, 2005 ; Yu et al, 2021 ).…”

Assessing sugar-sweetened beverage consumption in early pregnancy using a substance abuse framework

“…Many people with SUD experience other mental disorders. In the case of pregnant women, a growing number of studies have found that increased SSB consumption places them at higher risk of postpartum depression (PPD) 21 , 26 . This validates the experimentation of characterizing SSB as an SUD, for findings could help us make inferences about how it might affect PPD (Fig.…”