Depression common during the peripartum period

Major depressive disorder (MDD) is prevalent during the entire peripartum period, with the highest prevalence observed 2 weeks following childbirth, as shown in a study.

Researchers conducted a systematic review and meta-analysis. They searched multiple online databases for cross-sectional studies or longitudinal surveys that quantified MDD during pregnancy and up to 12 months postpartum among women and girls aged 10–59 years with singleton or full-term births across world regions.

A total of 1,025 studies were included in the qualitative synthesis. Two-stage analysis comprised 1,505 prevalence datapoints from 780 studies representing 2,018,198 women and girls from 90 countries and 19 world regions. In most studies, the participants received perinatal care from hospitals with population-representative catchments.

Compared with diagnostic interview, symptom scales overestimated the prevalence of MDD by between 71.3 percent with the Edinburgh Postnatal Depression Scale in the postpartum period and 121.9 percent with Patient Health Questionnaire during pregnancy.

The prevalence of MDD during the peripartum period was highest during the first 2 weeks after childbirth (p<0.0001) and remained significantly elevated throughout the postpartum year (p<0.0001).

In analyses controlled for changes over the peripartum period and biases due to measurement error, the overall prevalence of MDD was 6.2 percent at any point in time during pregnancy and 6.8 percent at any point in time during the postpartum year.

The prevalence of MDD was highest in southern sub-Saharan Africa, ranging from 15.6 percent during pregnancy to 16.6 percent during the postpartum year. This was followed by South Asia, where the prevalence ranged from 13.7 percent during pregnancy to 14.6 percent during the postpartum year. Conversely, the prevalence was lowest in high-income Asia Pacific, ranging from 3.1 percent during pregnancy to 3.3 percent during the postpartum year.

These findings highlight the importance of increasing integration of screening, prevention, and treatment of MDD during the peripartum period into existing models of care.