Characterization and stratification of the correlates of postpartum depression in sub-Saharan Africa: A systematic review with meta-analysis.

Journal: Women's health (London, England)

Volume: 18

Issue: 

Year of Publication: 2022

Affiliated Institutions:  Department of Physiotherapy, Evangel University Akaeze, Ebonyi State, Nigeria. Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria. Department of Obstetrics and Gynaecology, College of medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria. Department of Physiology, University of Nigeria Enugu Campus, Enugu, Nigeria. Department of Medical Rehabilitation, University of Nigeria Enugu Campus, Enugu, Nigeria.

Abstract summary 

Postpartum depression (PPD) is a common mental health challenge in resource-constrained sub-Saharan Africa (SSA). Characterizing its correlates will aid prediction, early detection, and pre-emptive interventions. This review aimed to systematically synthesize and stratify PPD correlates in sub-Saharan Africa. The review was structured as per the Preferred Reporting Item for Systematic Reviews and Meta-Analyses. We included studies that reported the correlates of PPD in SSA. We searched PubMed, Medline, CINAHL, Academic Search Complete, and PsycINFO for relevant peer-reviewed literature. The correlates of PPD constituted the primary outcome. A random effect model was fitted to estimate the pooled correlation coefficient per correlate. The clinical relevance of correlates was stratified based on strength of correlation (r) and recurrence (f). The mean age of the participants was 27.0 ± 6.0 years, and 68.6% of participants had completed at least secondary education. The correlates of PPD in SSA were intimate partner violence (IPV) ((risk weight (rw) = 2.8; r = 0.212 (confidence interval (CI): 0.11-0.31), poor social support (PSS) (rw = 1.9; r = 0.250 (0.133-0.361)), unwanted pregnancy (UP) (rw = 1.6; r = 0.279 (CI: 0.14-0.41); I = 95.89), and maternal age (MA) (rw = 0.96; r = 0.27 (CI: 0.154-0.37)), among others. A cumulative risk weight of ⩾0.95 was predictive of PPD and marks the critical point at which preemptive interventions should be instituted. The stratification of risk PPD factors and computation of risk stability index are useful in identifying the clinical significant risk factors. The provision of critical risk point will simplify early detection thus facilitating cost-effectiveness. Of the correlates of PPD in SSA, IPV, PSS, UP, and MA are the most important. Targeted screening and pre-emptive interventions for women with high risk weight may be a reasonable strategy both in the short and long term.

Authors & Co-authors:  Nweke Martins M Ukwuoma Maryjane M Adiuku-Brown Ada C AC Ugwu Princewill P Nseka Elizabeth E

Study Outcome 

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Statistics
Citations :  Gjerdingen DK, Yawn BP. Postpartum depression screening: importance, methods, barriers, and recommendations for practice. J Am Board Fam Med 2007; 20(3): 280–288.
Authors :  5
Identifiers
Doi : 17455057221118773
SSN : 1745-5065
Study Population
Women
Mesh Terms
Adult
Other Terms
depression;perinatal;risk;stratification;sub-Saharan Africa
Study Design
Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
United States