Psychosocial Risk Factors for Postpartum Depression in Chinese Women: A Meta-Analysis

Abstract

Background: Postpartum depression (PPD) has been identified as a recognized public health problem that may adversely affect mothers, infants, and family units. Recent research has identified risk factors for this disease in Westerners; however, a comprehensive study has yet to pool all evidence to provide estimates of psychological and social risk factors in China. Therefore, this study aimed to quantitatively assess all qualified studies and identify the psychological and social risk factors for postpartum depression in Chinese women.Methods: The following databases were used in the literature search from their inception until June 2019: PubMed, Embase, FMRS, China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI), and China Biology Medicine disc (CBM). Meta-analysis was conducted by RevMan software. Study heterogeneity and publication bias were estimated.Results: From a total of 887 identified studies, 48 were included in the analysis. Prenatal depression (OR 7.70; 95% CI 6.02-9.83) and prenatal anxiety (OR 7.07; 95% CI 4.12-12.13) were major risk factors for PPD. A poor economic foundation (OR 3.50; 95% CI 2.92-4.20) and a poor relationship between husband and wife (OR 3.42; 95% CI 2.82-4.13) were moderate risk factors. Minor risk factors included a poor relationship between mother-in-law and daughter-in-law (OR 2.89; 95% CI 2.12-3.95), a lack of social support (OR 2.57; 95% CI 2.32-2.85), unplanned pregnancy (OR 2.55; 95% CI 2.08-3.14), mother-in-law as the caregiver (OR 2.5; 95% CI 1.67-3.74) and poor living conditions (OR 2.44; 95% CI 1.92-3.10).Conclusions: This study demonstrated a number of psychological and social risk factors for postpartum depression in Chinese women. The major and moderate risk factors are prenatal depression, prenatal anxiety, a poor economic foundation and a poor relationship between husband and wife. These findings suggest that prenatal prevention aimed at these risk factors is important due to the presence of many of these factors during the prenatal period.