Postpartum depression and associated factors among postpartum women in Ethiopia: a systematic review and meta-analysis, 2020

Abstract

Introduction The postpartum period is recognized as a high-risk period for the development of various mood disorders like postpartum depression. Globally, postnatal depression is a serious public health problem that has a negative impact on the mother’s health and child development, especially in developing countries. In Ethiopia, even though there are different primary studies conducted on postpartum depression, there is no nationally representative evidence. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence and associated factors of postpartum depression in Ethiopia. Methods Published and unpublished articles from various electronic databases and digital libraries were accessed. This systematic review included studies that were conducted on the magnitude and factors associated with postpartum depression among postnatal women in Ethiopia. A random-effect model was used to estimate the pooled magnitude of postpartum depression with a 95% confidence interval (CI). Inverse variance (I2) was used to visualize the presence of heterogeneity, and forest plot was used to estimate the pooled magnitude of postpartum depression. Publication bias was assessed by funnel plots and Egger’s statistical tests. A meta-regression and subgroup analysis were computed to minimize underlying heterogeneity. Result Initially, a total of 764 studies were accessed. Twenty-eight full articles were assessed for eligibility criteria, of which twelve studies fulfilled inclusion criteria were included in the final meta-analysis. The overall pooled magnitude of postpartum depression was 22.89% (95% CI 17.75%, 28.03%) with the lowest (12.20%) and highest (33.82%) in the Southern nations region. Unplanned pregnancy, domestic violence, lack of social support, previous history of depression, infant loss, and dissatisfaction in marriage showed a statistically significant association with postpartum depression. Conclusions In the current analysis, the prevalence of postpartum depression was high as compared with other developing countries. Routine screening of mothers in the postpartum period and integrating mental health with maternal health care is highly recommended.

Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal

“…It could be due to the reason that unplanned pregnancies are most often associated with poor maternal wellbeing that may develop long-term adverse psychological consequences [ 49 ]. Also, inadequate birth preparedness and poor stress coping mechanisms particularly among socio-economic disadvantaged women may exacerbate the mental health problems during the postpartum period [ 50 , 51 ]. Therefore, screening during ANC visits to identify high-risk groups would be crucial to prevent PPD.…”

Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi

“…In addition, 50.4% of our participants had educational levels above secondary school level education which was higher than the study carried out in the Kibera slum (25.4%) where educational levels were significantly lower. In Kenya, PPD for women within the general population has been reported to be 18.7% ( 36 ) and a systematic review in Ethiopia found PPD to be at 22.89% ( 37 ) with another one in the same country reporting a prevalence of 23.7% ( 38 ). The higher PPD for this study population could be due to the greater challenges faced by people living with HIV in general as well as depression along with treatment fatigue being known side-effects of ART.…”

Assessment of magnitude and predictors of postpartum depression among mothers attending immunization clinics in Bihar, India

“…Recent studies conducted in Ethiopia (2020) noted that “domestic violence, lack of social support and dissatisfaction in marriage” were independent determinants of PPD. [ 26 ] Another study from China also reiterated that parents-in-law's preference to baby boy while undervaluing girl child and dissatisfaction with husband's support were strongly associated with significant PPD symptoms. [ 27 ] Thus, there is both agreement as well as disparities in the reporting of prevalence and predictors of PPD across India and the world.…”