Background: Birthing individuals experience various postpartum symptoms which have been associated with adverse health outcomes. Previous systematic reviews have focused on the examination of individual symptoms and their impact on health, which have limited our understanding of postpartum symptom clusters. Objective: To examine the compositions of symptom clusters, analytic methodologies and predictors of symptom clusters in birthing individuals up to 1 year postpartum. Design: Systematic review. Methods: This systematic review was reported following the PRISMA. Five databases were searched: PubMed, Embase, CINAHL Complete, PsycINFO and Scopus. Two reviewers performed title and abstract and full-text screening independently. StandardQuality Assessment Criteria were used to assess the articles' qualities. Key information was extracted into evidence table, which was checked for accuracy and completeness. A narrative synthesis was conducted.Results: A total of 30 articles were included. Studies were conducted in 16 countries, mostly in Europe (n = 9) and North America (n = 7). The majority were quantitative (n = 27) and cross-sectional (n = 27). Factor analysis was the most frequently used analytic methodology (n = 21). All three qualitative studies used grounded theory.Taking into consideration the variations among the studies, stress (n = 15, infant or partner-related and from other sources), depression (n = 12), somatic (n = 12) and anxiety clusters (n = 10) were most frequently identified. Symptom cluster predictors were examined in less than half of the included studies (n = 13). Among these, most were focused on how individual postpartum symptoms influence symptom clusters. Conclusions: Stress, depression, somatic and anxiety clusters are the most frequently identified postpartum symptom clusters. Future studies should examine the consistency, stability and clinical meaningfulness of these four symptom clusters. Relevance to clinical practice: The identification and management of the four symptom clusters should be of particular interest to clinicians and researchers.No patient or public contribution: This systematic review did not directly involve patient or public contribution to the manuscript.

Introduction This study aimed to identify the different types of social networks among young-old adults, and to examine the transitions in social networks as they become old-old adults. Methods This is a secondary data analysis using the longitudinal data ( N = 1092) from the National Social Life, Health, and Aging Project. Latent class analysis was conducted to identify optimal number of classes and latent transition analysis was conducted to examine the transition probabilities. Results Young-old adults in Class 1: family-oriented, social (close, external) transitioned into Class 2: family-oriented, non-social over time. In contrast, young-old adults in Class 2: family-oriented, non-social and Class 3: less family-oriented, social (close) were less likely to transition to another class. Conclusion Older adults engaged in less social activities over time. Older adults should be encouraged to continue their social engagement with close social network of friends and relatives, and to maintain their relationship with family members.

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