Prevalence and Risk Factors Associated with Postpartum Depression during the COVID-19 Pandemic: A Literature Review and Meta-Analysis

Abstract

Background: Owing to the high prevalence and detrimental consequences, postpartum depression (PPD) has been identified as one of the severe global public health issues in the last decade. Prior research found that during disasters or events, the prevalence rates of mental disorders among postpartum women are significantly high. However, the effect of the coronavirus disease 2019 (COVID-19) pandemic on PPD and its risk factors remained unclear for postpartum women. Therefore, the present systematic review and meta-analysis aimed to estimate the influence of the COVID-19 pandemic on the prevalence of PPD and to summarize risk factors for PPD during the COVID-19 pandemic. Methods: Three electronic databases of MEDLINE, EMBASE, and Cochrane library databases were systematically searched for articles from their commencements until 1 November 2021. Quality assessment of included studies, random-effects meta-analysis, and sensitivity analysis were performed. Results: A total of eight studies with 6480 postpartum women during the COVID-19 pandemic were included, and most studies were conducted in developed countries. The pooled prevalence of PPD was 34% (95% CI: 21–46%) during the COVID-19 pandemic, much higher than the incident of previous research during the non-pandemic period. Risk factors for PPD during the COVID-19 pandemic were defined as socio-demographic and clinical characteristics, stress and anxiety, lack of various supports, and the COVID-19 related factors. Conclusion: The research findings indicated that the COVID-19 pandemic could make detrimental effects on maternal mental wellbeing among women after childbirth. Investigating the prevalence and risk factors of PPD among postpartum women could shed some light on their mental and emotional states; so that support measures and tailored interventions from health professionals and policymakers could be offered to improve the maternal and infant outcomes, especially during the COVID-19 pandemic. Much more research on maternal psychological wellbeing during the COVID-19 pandemic was strongly recommended to undertake in the middle and low-income countries.

Prevalence of postpartum depression and its associated factors within a year after birth in Semey, Kazakhstan: A cross sectional study

“…The researchers also point to the need for a study on the prevalence of PPD in the middle and low-income countries. 7 According to the results of multivariate logistic regression, dissatisfaction with living conditions and cohabitation with the husband/ partner's parents was found to be a significant predictor of PPD. One possible explanation for this is the importance of cultural norms in the country.…”

“…6 However, more recently, the results of studies on the prevalence of PPD during the COVID-19 pandemic indicate two times (34% (95% CI: 21-46%)) higher prevalence of PPD among women than before the non-pandemic. 7 It is also worth noting that there are lack of papers to identify PPD in Central Asian countries, including Kazakhstan. 6 Kazakhstan achieved the Millennium Development Goal (MDG) 5 of reducing maternal mortality ratio and achieving universal access to reproductive health.…”

“…16 According to the meta-analyses by Chen Q. et al and Usmani S. et al, socio-demographic and clinical characteristics, stress and anxiety, lack of various supports, and the COVID-19 related factors were defined as the main risk factors for PPD during the COVID-19 pandemic. 7,17 Thus, we can observe several risk factors for the development of PPD among women, depending on the income, culture and traditions of the country, as well the epidemiological situation in the country.…”

Maternal Stress and Human Milk Antibodies During the COVID-19 Pandemic

“…The age of the child was considered a confounder and was adjusted for in our model. (26,28,(37)(38)(39)(40)(41)(42)(43). The studies that found higher stress levels were carried out at the onset of the pandemic.…”

The Impact of COVID-19 on Postpartum Depression and the Responsibility of the Healthcare System

“…While this is an astonishing trend, pregnant individuals were even more severely impacted. Prior to the global COVID-19 pandemic, the pooled prevalence of perinatal depression was found to be 11.9%, and postpartum depression was identified among approximately 10-15% of mothers in developed countries [9][10]. As of 2022, the pooled prevalence of depression was subsequently found to be 34% in postpartum individuals, an almost 10% difference from the general population and as high as a 24% increase from the postpartum depression prevalence pre-pandemic [9].…”