Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis

Mahendran, Rahini; Puthussery, Shuby; Amalan, Mahendran

doi:10.1136/jech-2018-211819

Cited by 50 publications

(52 citation statements)

References 48 publications

(29 reference statements)

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“…The full texts of the remaining 140 citations were evaluated, and 117 articles were excluded, which did not fulfill the eligibility criteria. Finally, 23 articles meeting all the criteria were recruited in this umbrella review (see Table 3), including 12 systematic reviews (Aggarwal and Berk, 2015;Arora and Aeri, 2019;Hossain et al, 2017Hossain et al, , 2014Math and Srinivasaraju, 2010;Mills et al, 2008;Mirza and Jenkins, 2004;Nadkarni et al, 2013;Naskar et al, 2017;Newman, 2013;Rajapakse et al, 2013;Thapa et al, 2018) and 11 meta-analyses (Chauhan et al, 2019;Ganguli, 2000;Hendrickson et al, 2019;Hussain et al, 2018;Mahendran et al, 2019;Malhotra and Patra, 2014;Pilania et al, 2019;Prabhu et al, 2019;Ranjan and Asthana, 2017;Reddy and Chandrashekar, 1998;Upadhyay et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the reviews evaluated mental disorders in India (n = 13), followed by two studies on Bangladesh (Hossain et al, 2014;Newman, 2013), one study each from Nepal (Thapa et al, 2018), Pakistan (Mirza and Jenkins, 2004), and Sri Lanka (Rajapakse et al, 2013). One study evaluated mental disorders among Bhutanese refugees living in Nepal (Mills et al, 2008), and four studies evaluated mental disorders in multiple South Asian nations (Hossain et al, 2017;Mahendran et al, 2019;Prabhu et al, 2019;Ranjan and Asthana, 2017). The quality evaluation found one study with low quality, nine studies with high quality, and remaining (n = 13) studies with medium quality (see Supplementary material).…”

Section: Characteristics Of the Recruited Reviewsmentioning

confidence: 99%

“…Fourteen studies reported the prevalence of depressive disorders among different population groups ranging from 0.5% to 97%, which was heterogeneous among participants with diverse sociodemographic and pathophysiological conditions (Aggarwal and Berk, 2015;Arora and Aeri, 2019;Hossain et al, 2014;Hussain et al, 2018;Mahendran et al, 2019;Mills et al, 2008;Mirza and Jenkins, 2004;Naskar et al, 2017;Newman, 2013;Pilania et al, 2019;Prabhu et al, 2019;Reddy and Chandrashekar, 1998;Thapa et al, 2018;Upadhyay et al, 2017). For example, Newman (2013) reported the prevalence of depression was 6.6% to 37% among the general population, whereas 97% of patients with fistula experienced depressive disorders (Newman, 2013).…”

Section: Depressive Disorders Anxiety Disorders and Mood Disordersmentioning

confidence: 99%

“…The severity of depressive disorders also varied with age; another meta-analysis found 34.4% (95% CI: 29.3-39.7) of elderly adults had depressive disorders (Pilania et al, 2019). Moreover, maternal depressive disorders was reported in five reviews (Arora and Aeri, 2019;Mahendran et al, 2019;Newman, 2013;Prabhu et al, 2019;Upadhyay et al, 2017). A meta-analysis reported the prevalence of antenatal depressive disorders as 24.3% (95% CI: 19.03-30.47) (Mahendran et al, 2019), whereas another meta-analysis reported the prevalence of postpartum depressive disorders as 26% (95% CI: 21-30) (Prabhu et al, 2019).…”

Section: Depressive Disorders Anxiety Disorders and Mood Disordersmentioning

confidence: 99%

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Prevalence of mental disorders in South Asia: An umbrella review of systematic reviews and meta-analyses

Hossain

Purohit

Sultana

et al. 2020

Asian Journal of Psychiatry

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Objectives: Mental disorders are highly prevalent in eight South Asian countries, yet there is a gap of a synthesized overview of the prevalence of mental disorders in this region. This umbrella review aims to summarize the prevalence of mental disorders from systematic reviews and metaanalyses of South Asian studies. Materials and methods: A systematic search of 11 major databases and additional sources was conducted until December 11, 2019. Articles were included if they were systematic reviews or meta-analyses, reported the prevalence of mental disorders, and reported primary studies conducted in South Asian countries only. Results: Among 2591 citations, a total of 23 reviews met all the criteria of this umbrella review. The synthesized findings from those reviews suggest high prevalence rates for mental disorders, including depressive disorders, anxiety disorders, mood disorders, suicidal behavior and selfharm, schizophrenia, substance use disorders, neurodevelopmental disorders, dementia, and other mental health problems. Also, findings suggest a high burden of maternal depression, psychiatric comorbidities in chronic physical illnesses, and various mental disorders among children, elderly adults, refugees, and other vulnerable populations. Most studies were from India whereas evidence from Afghanistan, Bhutan, and Maldives was limited. Conclusion: The findings of this review are constrained with heterogeneity in prevalence estimations, methodologies, sampling issues, and limitations in the existing literature, which should be addressed in future research. The evidence synthesized in this review provides national and regional overview of the prevalence of mental disorders, which may inform better policymaking and practice advancing mental health in South Asia.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of the Recruited Reviewsmentioning

confidence: 99%

Section: Depressive Disorders Anxiety Disorders and Mood Disordersmentioning

confidence: 99%

Section: Depressive Disorders Anxiety Disorders and Mood Disordersmentioning

confidence: 99%

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Prevalence of mental disorders in South Asia: An umbrella review of systematic reviews and meta-analyses

Hossain

Purohit

Sultana

et al. 2020

Asian Journal of Psychiatry

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“…Meta-analysis is a useful tool for the detection of disease − gene relationships [16]. In the Chinese Han population, one meta-analysis showed no association between the RGS4 gene and the risk of schizophrenia [15]; however, in another meta-analysis, the SNP, rs951436, was found to be associated with the risk of schizophrenia [17].…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of the association between RGS4 gene polymorphisms and schizophrenia

Xu¹,

Wang²,

Liu

et al. 2020

Preprint

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Background: Schizophrenia is a complex brain disorder, the pathogenesis of which remains unclear.Regulator of G-protein signaling 4 ( RGS4 ) is regarded as a candidate gene for schizophrenia risk. The association between the RGS4 gene and the risk of schizophrenia is complicated and controversial, thus, an updated meta-analysis is needed. Methods: A search strategy using Medical Subject Headings was developed in English (PubMed, SZGene) and Chinese (CNKI, Wanfang and Weipu) databases. Inclusion and exclusion criteria were used to screen for eligible studies. Parameters, such as P -value of Hardy − Weinberg equilibrium ( P HWE ), odds ratios (ORs), 95% confidence intervals (CIs), P -values of association ( P z ,), heterogeneity ( P h ), and publication bias ( P e ), were analyzed by the Stata software using a random effects model. Subgroup analyses were performed to detect heterogeneity. Results: There were 15 articles regarding rs10917670 (8,046 cases and 8,837 controls), 16 regarding rs951436 (8,990 cases and 10,568 controls), 15 regarding rs951439 (7,995 cases and 8,646 controls), 15 regarding rs2661319 (8,320 cases and 9,440 controls), and 4 regarding rs10759 (2,752 cases and 2,866 controls). The frequencies of rs10917670 and rs951439 were not significantly different between the case and control groups (p > 0.05). As shown by the East Asian and hospital-based subgroup analyses, the genotype TT of rs951436 might be related to the risk of schizophrenia. The genotypes CC+CT of rs2661319 and CC+CA of rs10759 were statistically different between the two groups, and the East Asian population contributed to these differences. Conclusion:The genotypes CC+CT of rs2661319 and CC+CA of rs10759 might be associated with the risk of schizophrenia.

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Maternal Prenatal Depressive Symptoms and Fetal Growth During the Critical Rapid Growth Stage

Zhang,

Li,

et al. 2023

JAMA Netw Open

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ImportanceFetal growth in the critical rapid growth stage (CRGS) before delivery, approximately between 30 to 37 gestational weeks, carries significant implications for subsequent overweight, obesity, and arterial health. Previous evidence has demonstrated the association between maternal depressive symptoms and fetal growth trajectories from early to late pregnancy, but there remains limited understanding of the association of these symptoms with the longitudinal fetal growth change within the CRGS.ObjectiveTo investigate the association between maternal depressive symptoms and fetal growth during the CRGS before delivery.Design, Setting, and ParticipantsThis prospective birth cohort study was conducted from January 2018 to December 2020. Volunteer pregnant women were enrolled in their first trimester of prenatal visits. Women with severe disease before pregnancy and multiple births, fetuses with congenital anomalies, and preterm or postterm births were excluded. This multicenter study was based in 13 hospitals covering 81 counties across 12 cities in Sichuan Province, China. Follow-up visits were performed at the second trimester, the third trimester, and 24 hours after delivery. The analysis was conducted from January to May 2023.ExposuresMaternal depressive symptoms, as a continuous variable, measured by the Edinburgh Postpartum Depression Scale (EPDS) at a median gestational week of 24 (range, 14 to 27) weeks of gestation. A higher score on the EPDS indicates worse depressive symptoms.Main Outcomes and MeasuresThe main outcomes included ultrasonography-measured biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC), along with calculated estimated fetal weight (EFW). These parameters were evaluated longitudinally at a median gestational week of 30 (range, 28 to 32) and 37 (range, 35 to 39) weeks. Linear mixed models were used to estimate the associations between maternal depressive symptoms and fetal growth parameters.ResultsA total of 2676 mother-offspring dyads were included, in which the mean (SD) age of mothers was 28.0 (4.4) years, and 1294 (48.4%) of the offspring were female. The median (IQR) maternal EPDS score was 5.0 (4.0 to 9.0). After adjustment for confounders, a significant correlation was found between a higher score of depressive symptoms in mothers and a slower rate of fetal growth across FL (β = −0.40; 95% CI, −0.58 to −0.22), AC (β = −1.97; 95% CI, −2.90 to −1.03), and EFW (β = −50.11; 95% CI, −68.46 to −31.75). These associations were stronger in female fetuses or those with better family socioeconomic conditions.Conclusions and RelevanceIn this prospective cohort study, maternal depressive symptoms were associated with slower fetal growth rate in the CRGS before delivery. Early screening for depressive disorders in pregnant women appears to be essential for fetal growth and later health.

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Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis

Cited by 50 publications

References 48 publications

Prevalence of mental disorders in South Asia: An umbrella review of systematic reviews and meta-analyses

Prevalence of mental disorders in South Asia: An umbrella review of systematic reviews and meta-analyses

A meta-analysis of the association between RGS4 gene polymorphisms and schizophrenia

Maternal Prenatal Depressive Symptoms and Fetal Growth During the Critical Rapid Growth Stage

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