Prevalence of postpartum depression symptoms in developed and developing countries in the COVID-19 pandemic: a systematic review with meta-analysis
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Oswaldo Cruz Foundation (Fiocruz), Brazil
Fiocruz, Brazil
Fundação Oswaldo Cruz (Fiocruz), Brazil
Federal University of Rio de Janeiro, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A506
Background: The prevalence of postpartum depression (PPD) possibly increased during the COVID-19 pandemic due to numerous direct and indirect stressors associated with the virus as well as modifications to the social, economic, and health landscape. Objective: We aimed to carry out a systematic literature review of cross-sectional studies that assessed the prevalence of PPD symptoms in the pandemic, then meta-analyze and compare the prevalence between developed and developing countries. Methods: Studies published on PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO and Cinahl from inception to October 2022, that reported prevalence of PPD symptoms, using Edinburgh Postnatal Depression Scale, among puerperal women aged ≥ 18 were included. Quality assessment was performed according to Joanna Briggs Institute Critical Appraisal Checklist.  The metaprop command was used in the Stata statistical software v.12.0 to run a random-effects meta-analysis. Heterogeneity was explored by subgroup analysis and meta-regression, considering human development index (HDI), age, time after childbirth, breastfeeding and parity.  Results: The initial search strategy identified 691 articles. A total of 15 studies with 4788 postpartum women during the COVID-19 pandemic were included. Seven studies were conducted in developed countries and eight in developing countries. The overall prevalence of PPD symptoms was 31% (95% CI: 21.85-40.99). The pooled prevalence of PPD symptoms among women from developed countries [30,5% (95% CI: 16.95–46.02)] did not differ significantly from that in developing countries [31,5% (95% CI: 19.26–45.15)]. In the meta-regression, the proportion of breastfeeding was direct associated with the prevalence of PPD (β=0.006, p=0.04). Studies that analyzed women up to one month after childbirth had a lower prevalence of PPD compared to those that observed them up to one year after childbirth. High heterogeneity was detected across studies.
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