A Systematic Review On The Prevalence of Postpartum Depression and The Associated Risk Factors in Asia

Volume 6, Issue 7, July – 2021 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
A Systematic Review on the Prevalence of

Postpartum Depression and the associated Risk
Factors in Asia
Authors
S. Kalyani Professor, Ph.D Research Scholar, Counselling Psychology, Chettinad Academy of Research
and Education, Kelambakkam, Chengalpattu Dist., Chennai - 603103, India.
Dr. C. N. Ram Gopal Professor, Counselling Psychology, Chettinad Academy of Research and Education,
Kelambakkam, Chengalpattu Dist., Chennai - 603103, India.
Abstract:- Keywords:- “Postpartum” or “Postnatal” or

Background “Perinatal”,”Depression” or
Postpartum Depression is a major mental health concern “Distress””Prevalence”or”Incidence”,”India” and”Asia”
affecting mothers and their infants. Various studies and “Arabic Region”
have been conducted across the Asian continent to
estimate the prevalence and the risk factors associated I. INTRODUCTION
with Postpartum Depression.The main objective of this
current review is to determine the burden of postpartum A new-born can bring a whirlwind of excitement and
depression in across the Asian continent to synthesize the but at the same time it can be one of the most stressful and
important risk factors and to provide evidence-based tiresome phases for many mothers. As a woman transitions
data inorder to prioritize maternal mental health and into the role of a mother, she witnesses a challenging period
wellbeing. This review aims to assess the prevalence of that involves significant psychological, social and
Postpartum Depression in Asia and to ascertain risk physiological changes. The broad spectrum of postpartum
factors for PPD in the period 2000-2020. psychiatric disorders can be divided into three categories:
Methods postpartum blues; postpartum psychosis and postpartum
The literature search was done using electronic database depression.(1,2) Postpartum blues, has a prevalence of 300‒
like PubMed, Elsevier, PlusOne, Research Gate and 750 per 1000 mothers globally, may resolve in a few days to
Google Scholar. Search terms like postnatal depression, a week, has a minimal negative impact and usually requires
postpartum depression, risk factors, Asian Mothers were only reassurance.(1)The American Psychological
used to find relevant literature. Association describes postpartum depression(PPD) as, “a
Result serious mental health issue characterized by a prolonged
Fifty-eight studies about postpartum depression were period of emotional disturbance, occurring at a time of
selected that were conducted across various Asian major life change and increased responsibilities in the care
countries. The prevalence of postpartum depression of a new-born infant”. The prevalence of PPD has been
varied widely due to the different cut off points and estimated as 100‒150 per 1000 births. (3) A meta-analysis
varying timelines used in different studies.2 Studies in performed by WHO reports that the burden of perinatal
India (Gujarat and Karnataka) recorded the highest mental health disorders is high in low- and lower-middle-
prevalence 48.50% and 46.90% respectively.2 Studies income countries (1). It has also been difficult to establish
conducted in Iran and Kuwait recorded the highest prevalence of PPD because of underreporting by mothers
prevalence 40.40% and 45.90% respectively. 20 studies themselves. Symptoms of PPD are often underestimated by
recorded a prevalence rate between 20%-40%. 6 studies both mothers and care providers as normal, natural
estimated a prevalence less than 15%. The risk factors consequences of childbirth. A meta-analysis in developing
associated with PPD were classified under five different countries showed that the children of mothers with
categories. They are 1.Socio-demographic postpartum depression are at higher risk of being
variables,2.Pregnancy and Birth Related underweight and stunted growth. Moreover, mothers who
Variables,3.Infant Variables,4.Family Relationships and are depressed are more likely not to breastfeed their babies
Psychosocial factors. and do not seek appropriate health care. (4) A World Health
Conclusion Report states that maternal depression results in lower birth
The review highlights the burden of Postpartum weight of infants, higher rates of underweight at 6 months of
depression and recommends frequent screening for age, poor long-term cognitive development, higher rates of
maternal distress in the last trimester of pregnancy and antisocial behaviour and more frequent emotional problems
in the post-partum period needs to be carried out by among their children.(5) Despite the launch of India’s
health care workers when mothers come for their national mental health programme in 1982, maternal mental
postnatal review or at the immunization clinics. health is still not a significant part of the programme. There
IJISRT21JUL376 www.ijisrt.com 363

ISSN No:-2456-2165
is a deficit in dedicated maternal health services in health- postpartum depression, risk factors, Asian Mothers were
care facilities, and health workers lack mental health used to find relevant literature. Studies were eligible for
training. The availability of mental health professionals is review if they a) were conducted in the period 2000-2020b)
limited or non-existent in peripheral health-care facilities. In assessed the risk factors) conducted in Asia. Studies about
addition to that, there is currently no screening tool designed treatment methods or interventions, studies about biological
for use in clinical practice and no data are routinely and genetic risk factors; studies about antepartum depression
collected on the proportion of perinatal women with unless they were about both ante- and postpartum depression
postpartum depression. (6) were excluded.
II. OBJECTIVES & FEATURES IV. RESULTS
Our current understanding of the epidemiology of Fifty-eight studies about postpartum depression were
postpartum depression is largely based on a few regional selected that were conducted across various Asian countries.
studies. The main objective of this current review is to fill The studies are grouped under studies performed in India, in
this gap, by providing an updated estimate of the burden of the Arabic Region and other Asian countries like Pakistan,
postpartum depression in across the Asian continent to Japan, China etc. It is to be noted that 31 studies from
synthesize the important risk factors and to provide India,11 studies from the Arabic region and 16 studies from
evidence-based data for prioritizing maternal mental health other Asian countries were reviewed for this study. The
and wellbeing. This review aims to assess the prevalence of special feature of this study is that studies conducted across
PPD in Asia and to ascertain risk factors for PPD in these a time span of 20 years (2000-2020) have been chosen for
settings. Although systematic reviews were published based this systematic review .Of the 58 studies, the majority of 32
on studies from India, Arabic Region and other Asian studies have been conducted in the very recent time period
countries individually for different time lines, there is no 2015-2020.It is significant to note that a maximum of 22
comprehensive review of postpartum depression prevalence studies in the recent time period 2015-2020 were conducted
and associated risk factors across the Asian continent for a in various states of India like Maharashtra, Madhya Pradesh,
vast time period of 2000-2020. Delhi, Gujarat and Karnataka.16 studies are chosen which
fall under the time period 2010-2015.8 studies have been
III. METHODOLOGY conducted during 2000-2009.Moreover 55 out of 58 studies
analysed the risk factors associated with PPD. Please refer to
The literature search was done using electronic Table 1 indicating the number of studies contributed from
database like PubMed, Elsevier, PlusOne, Research Gate three geographical regions India, Arabic Region and other
and Google Scholar. Search terms like postnatal depression, Asian countries.
Table 1: Geographic distribution and number of studies across India, Arabic Region & other Asian
Countries during 2000-2020
India Arabic Region Other Asian Countries
Place of Study No. of studies Place of Study No. of studies Place of Study No. of studies
Tamil Nadu 3 Riyadh 1 Srilanka 1
Pondicherry 1 Saudi Arabia 1 Pakistan 2
Kerala 2 Sudan 1 Philippines 1
Pondicherry 1 Jordan 1 China 2
Andhra Pradesh 3 Bahrain 1 Iran 3
Karnataka 5 Cyprus 1 Indonesia 1
Gujarat 4 Lebanon 1 Turkey 1
Goa 1 Laos 1 Maldives 1
Madhya Pradesh 2 Syria 1 Vietnam 1
Maharashtra 2 UAE 1 Oman 1
Delhi 2 Kuwait 1 Thailand 1
Nepal 3
Assam 1
Rajasthan 1
Jharkhand & Orissa 1

ISSN No:-2456-2165
Fig 1.1 showing the geographical distribution of studies generalise the results to the entire population. However,
across Asian continent during 2000 -2020 community studies when compared to hospital studies had a
bigger sample size. There were exceptions like the study
conducted in Thailand had a huge sample size of 1731
samples.
Scale of Measurement
Out of 58 studies,46 studies used Edinburg Postpartum
Depression Scale (EPDS) to screen postpartum Depression.
However, different cut off scores were used in different
studies). A systematic review by Gibson et al. stated that
cut-off points at 9 ⁄ 10 and 12 ⁄ 13 for PPD were widely
accepted cut-off points to indicate possible and probable
depression respectively.(7)The sensitivity of the English
Version of EPDS was 86% and the specificity was
Time & Place of Recruitment 78%.However, different cut off scores were used in different
All the 58 studies recruited mothers in their postnatal studies. In 15 studies, the cut-off score was calculated at
period. Please refer Table 1 showing the Geographic ≥13.In 4 studies the cut off score used was >13.4 studies
distribution and number of studies across India, Arabic used a cut-off score ≥12.7 studies used a cut-off score >12.6
Region & other Asian Countries during 2000-2020.The studies used a cut-off score ≥10.1 study used a cut-off score
initial screening was done in a range of 1-8 weeks. Some 10 ,1 study used 10,5 and another study used a cut-off score
studies followed up participants until 12 months postpartum. 9.In a study conducted in Jordan, the EPDS score were
Twenty-two studies from various states in India recruited classified as mild, moderate and severely depressed. The
mothers from Hospitals for the studies.11 studies from mild score range was calculated at 10-15, the moderate score
Arabic Region and 11 studies from other Asian countries range was calculated at 16-20 and the severe score range
recruited mothers from Hospitals. It is also significant to was calculated >21.In India, the English Version of EPDS
note that 4 studies in China (8 centres) ,Saudi Arabia(5 was translated to the regional languages like Tamil,
centres), Sudan(2 centres) and Jordan(4 centres) performed Kannada, Guajarati and Assamese. In the other Asian
multi centre hospital studies.12 studies were exclusively countries like Thailand, the Thai version of EPDS scale was
community based studies wherein 6 studies were conducted used. Arabic and Persian version of the scale was used in
in India and 6 in other Asian countries.2 studies conducted Arabic region. In a study conducted in Vietnam and Turkey,
in Madhya Pradesh and Nepal recruited mothers from a the Vietnamese and Turkish version of the scale was used
combination of hospital and community. accordingly. Please refer Table 2 showing the summary of
the studies with prevalence and tools used
Study Design
Forty-two studies adopted a cross sectional research Apart from EPDS being used to screen postpartum
design to estimate the prevalence of PPD. Longitudinal depression, other tools were also used in some studies. In a
panel approach was adopted only by 9 studies wherein the study conducted in Andhra Pradesh, the Hamilton Rating
mothers were screened for PPD multiple times in different scale for Depression. The screening categories were 0-8 :
time intervals to assess the level of depression. The other Low probability depression 8-12 : Baby blues 13-14 :
research designs used across the remaining studies used a Possibility of depression 15+ : Highly probability of
case control study to determine the risk factors, Quasi depression. In a study conducted in Gujarat, Predictive
Experimental Study, observation study, randomised control Index for PPD was used to screen depression. The Kessler-
trial. 10 item scale was used to screen depression in Jharkhand
and Orissa. A combination of Brief Psychiatric Rating Scale
Sampling Size & Sampling Method (BPRS), Hamilton Anxiety Rating Scale (HARS), and
8 studies used the Probability Sampling Method Hamilton Rating Scale for Depression (HDRS) was used to
wherein simple random Sampling was used in 3 studies screen depression in a study conducted in Delhi. In a study
(Madhya Pradesh, Bahrain and Iran. Cluster sampling was conducted in Pakistan, Aga Khan University Anxiety and
used in a study conducted in Karnataka and Indonesia. Depression Scale (AKUADS) was used. A study conducted
Systematic Random Sampling was used in Assam. In a in Zabol (Iran) used Beck Depression Inventory to screen
Study conducted in Thailand, Stratified Multistage sampling the level of PPD.
was used for Stage 1 and Simple Random Sampling was
used in Stage 2.17 Studies used the Non-probability V. PREVALENCE OF POSTPARTUM
Sampling techniques. It was used in 1 study conducted in DEPRESSION
Tamil Nadu,1 conducted in Andhra Pradesh and 2
conducted in Gujarat. Convenient Sampling was used in The prevalence of postpartum depression varied
studies conducted in Maharashtra, Pakistan, Jordan, Kuwait, widely due to the different cut off points and varying
Riyadh and Syria. Consecutive sampling was used in studies timelines used in different studies. Please refer Table 2
conducted in Karnataka, China and Vietnam. In many showing the summary of the studies with prevalence and
studies the small sample size became a major limitation to tools used.2 Studies in India (Gujarat and Karnataka)

ISSN No:-2456-2165
recorded the highest prevalence 48.50% and 46.90% study conducted in Jordan in 2013, had classified the level
respectively.2 Studies conducted in Iran and Kuwait of depressive symptoms as mild - 10-15, moderate - 16-20,
recorded the highest prevalence 40.40% and 45.90% severe->21.The results were the number of mothers with
respectively.6 studies estimated a prevalence less than mild symptoms were 39%, the number of mothers with
15%.Of the 6 studies,4 of them were estimated in moderate symptoms were 28% and the number of mothers
India(Tamil Nadu, Pondicherry, Gujarat and Delhi- with severe symptoms were 16%.
Prevalence % 11%,10.2%,12.5% and 12% respectively) and
2 of the in China and Thailand(7.45% and 8.4% A study conducted in Madhya Pradesh estimated the
respectively).20 studies recorded a prevalence rate between prevalence using Patient Health Questionnaire (PHQ-9).It
20%-40%.,12 studies were conducted in India and 8 were was a study based on Community and Facility. The
conducted in other Asian countries like Pakistan, percentage of prevalence in the community was 8.8% and
Philippines, Turkey, Vietnam, Iran, Bahrain Laos, Syria and the facility was 18.5% . A study conducted in Andhra
Azerbaijan. The minimum rate of prevalence recorded was Pradesh in 2016 had employed the Hamilton Rating scale
20% in Gujarat and the maximum recorded was 40.4% in for Depression to screen depressive symptoms and the cut
Iran. off range for various stages were given as 0-8 : Low
probability depression 8-12 : Baby blues 13-14 : Possibility
8 studies were performed with a cut-off score of of depression 15+ : Highly probability of depression. In a
>10,>10.5 and ≥10 . One study conducted in Gujarat using a longitudinal study conducted in Oman, depressive
cut-off score of >10.5 reported a high percentage of symptoms were screened at 2 and 8 weeks postpartum with
prevalence of 48.5%.31 studies were conducted with the a prevalence rate of 13.5% and 10.5% respectively. This
EPDS cut-off scores as ≥11,>12, ≥12,13, ≥13.One amongst study reported that out of 236 mothers ,74 mothers (i.e)
these 31 studies was conducted in Indonesia in the year 2018 31.4% of mothers had depressive symptoms. In a cross
used a prospective longitudinal research design and the sectional study conducted in Karnataka ,it was observed that
screening was performed at 1,2 and 3 months postpartum. the mothers who underwent C-Section had a prevalence rate
The percentage of prevalence was 18.37%, 15.19%, and of 20% when compared to the mothers who had vaginal
26.15% at one, two and three months respectively. birth had a prevalence of 16%. As mentioned earlier, the
Furthermore, there were 2 studies conducted in Karnataka variation in the level of prevalence has been majorly based
and Srilanka using an EPDS score >9.The rate of prevalence on the sample size, the tool used for measurement and the
in the study in Karnataka was recorded as 18%.In the study time period of evaluation (no. of weeks postpartum and the
conducted in Srilanka ,the samples were divided into S1 and cut-off score).
S2.S1 recorded a prevalence of 15.5% and S2 AT 7.8%. One
Table 2. showing the summary of the studies with prevalence and tools used
Author and Research Cut off Data collection No of No of mothers with
Setting Tools
Place of Study Design score period women PPD
India
2-3 days
Latha et al(2017) EPDS(Ta postpartum,6-8
Hospital Case control >12 256 23%
Tamil Nadu mil) weeks
postpartum
Shriraam, et
Cross 6 weeks
al(2019) Hospital EPDS ≥10 365 11%
sectional postpartum
Tamil Nadu
Chandran et randomised last trimester,
CIS-
al(2002) Community placebo NA 6-12 weeks 359 11%
R(Tamil)
Tamil Nadu control trial postpartum
Poomalar GK et
Cross
al(2014) Hospital EPDS ≥13 NA 254 26(10.2%)
sectional
Pondicherry
Santhosh
Kuriakose et Cross 2-4 weeks upto
Hospital EPDS ≥11 250 27.60%
al(2020) sectional 1 year
Kerala
Heera Shenoy et
Cross
al(2019) Hospital EPDS >13 2-6 weeks 119 35(29.4%)
sectional
Kerala

ISSN No:-2456-2165

Setting Tools
30(30% - mild
Ch. Beaula Rani
Cross depression & 18%
et al(2019) Community EPDS NA NA 100
sectional moderate
Andhra Pradesh
depression)
11(18.33%) of them
had low probability
of depression,
33(55%) of them had
P. Latha et baby blues,
Cross
al(2016) Hospital EPDS NA 0-6 weeks 60 11(18.33%) of them
sectional
Andhra Pradesh had high probability
of depression,
5(8.33) of them had
possibility of
depression
0-8 : Low
probabilit
y
depression
8-12 :
Baby
Hamilton
Lakshmi blues 13-
prospective Rating
Bhuvana G et 14 : 1 week
Hospital observationa scale for 236 74(31.4%)
al(2016)Andhra Possibility postpartum
l study Depressi
Pradesh of
on
depression
15+ :
Highly
probabilit
y of
depression
Siddharudha
Shivalli et Cross
Hospital EPDS ≥13 4-10 weeks 118 31.40%
al(2015) sectional
Karnataka
Avita Rose
Johnson et Cross
al(2015) sectional
Karnataka
Anamika
Agarwala et Cross
Hospital EPDS ≥10 6 months 410 21.50%
al(2019) sectional
Karnataka
Ganraj Bhat
Sankapithilu et Cross 0-3 months 20%(10)-C-
Hospital EPDS >12 100
al(2010) sectional postpartum SEC,16%(8)-Normal
Karnataka
Suguna A et
Cross
al(2015) Hospital EPDS >9 NA 180 18%
sectional
Karnataka
Desai Nimisha D
Cross upto 1 year
et al(2012) Hospital EPDS NA 200 12.50%
Gujarat

ISSN No:-2456-2165

Setting Tools
Himadri L. Patel
Cross
et al(2015) Hospital EPDS >10.5 NA 134 48.50%
sectional
Gujarat
(22-30)-
10/4%
Vidhi Prakash (12-21)-
Cross
Modi et al(2018) Hospital EPDS 16.4% 1-6 weeks 250 20.40%
sectional
Gujarat <12-
199(79.6
%)
Dr. Darshana
Cross
Hirani(2015) Community EPDS ≥10 1-6 weeks 516 12.00%
sectional
Gujarat
Vikram Patel et 6-8 weeks and 6
al(2002) Hospital NA EPDS NA months 270 59(23%)
Goa postpartum
224-
Sujit D. Commun
Community Cross 8.8% - community &
Rathod(2018) EPDS NA ity
& Facility sectional 18.5% - facility
Madhya Pradesh &130-
Facility
Gita Guin et prospective
al(2018)Madhya Hospital observationa EPDS ≥13 NA 500 64(12.8%)
Pradesh l study
Mean Scores - s
Dhwani.Prakash.
6 weeks 1.58, 10.58 and
Sidhpura et Observation MKS
Hospital ≥10 primparous 300 14.80 of upper,
al(2018) al Study &EPDS
women middle and lower
Maharashtra
SES women
Nikhil
Cross 1-6 weeks
Dhande(2018) Community EPDS NA 67 24%
Maharashtra
Saurav Basu et
Cross less than 1 year
al(2019) Hospital EPDS ≥10 210 61(29%)
sectional infant
Delhi
Adya Shanker
BPRS,H 1st day to 4
Srivastava et longitudinal 12% depression,4%
Hospital ARS,HD NA weeks 100
al(2015) study anxiety
RS postpartum
Delhi
Kamal Narayan
Cross
Kalita et al(2010) Hospital EPDS >13 6 weeks 100
sectional
Assam

ISSN No:-2456-2165

Setting Tools
SIGNE Hospital and Cross

EPDS >12 5-10 weeks 426 17%
DØRHEIM HO- Community sectional
YEN(2007)
Nepal
N Shrestha et
al(2015) Community cohort EPDS >13 6 weeks 200 20(10%)
Nepal
Arju Chand Cross

Hospital EPDS ≥13 100 17%
Singh et al(2019) sectional
Nepal
Kirti Iyengar et
longitudinal 6-8 weeks and
al(2012) Community EPDS NA 1542
study 12 months
Rajasthan
Audrey
Kessler-
Prost(2012) Cross
Community 10 item NA 6 weeks 5801 11.50%
Jharkhand & sectional
scale
Orissa
Arabic Region
Raneem Seif Al
Cross
Nasr et al(2020) Hospital EPDS 174 67(38.5%)
sectional
Riyadh
≥12
Lamia I. 10-12
Alasoom et Multicenter Cross Moderate
EPDS 450 17.80%
al(2014)Saudi Hospital -5 sectional ≥13 -
Arabia severe
Dina Sami
Multicenter Cross
Khalifa et EPDS 3 months 238 20(9.2%)
Hospital -2 sectional
al(2016) ≥12
mild - 10-
Dalal Bashir 15
Multicenter
Moh’d Yehia et Cross moderate -
Military EPDS 300
al(2013) sectional 16-20
Hospital -4
Jordan severe-
>21
F.H. Al Dallal et
Cross 8 weeks
al(2012) Hospital EPDS ≥12 237 37.10%
Bahrain
Martha Moraitou
Cross EPDS 1 week
et al(2010) Hospital >12 226 13.70%
sectional and BDI postpartum
Cyprus
3-5 months
M. Chaaya et al Community NA EPDS >12 396 21%
postpartum
Souphalak
Inthaphatha(2020 Cross 6-8 weeks
Hospital EPDS ≥10 428 31.80%
) sectional postpartum
Laos
Mayada Roumieh
Cross 3-4 weeks
et al(2019) Hospital EPDS ≥13 1105 28.20%
Syria

ISSN No:-2456-2165

Setting Tools
KATHERINE
3 months and 6
GREEN et longitudinal
Hospital EPDS ≥13 months 125 22%
al(2006) study
postpartum
UAE
Nour Alhamdan
Cross
et al(2017) Hospital EPDS 6 months 658 45.90%
sectional
Kuwait
≥12
Other Asian Countries
Qiping Fan et S1 -
Cross 10 days,4 S1 - 15.5%,S2 -
al(2019) Hospital EPDS >9 523,S2 -
sectional weeks 7.8%
Srilanka 826
Tashakori A et
Cross 1 week
al(2009) Hospital EPDS >12 210 21.40%
Pakistan
Home
environment/F
amily
relationship
questionnaire,
Quasi-
Niloufer S Ali et Post-natal
experime 1,2,6,12 months
al(2009) Community questionnaire, NA 420 28.80%
ntal postpartum
Pakistan Aga Khan
study
University
Anxiety and
Depression
Scale
(AKUADS):
Self-Reporting
Questionnaire
(SRQ), Brief
Atif Disability
longitudi
Rahman(2007)Pa Community Questionnaire NA 3,6,12 months 701 73 (56%)
nal study
kistan (BDQ), and a
modified Life
Events
Checklist.
Maria Delina E et
Cross 2-8 weeks
al(2014) Hospital EPDS >10 115 22.61%
Philippines
Chinese
Version of
Edinburgh
Postnatal
Ai-Wen Deng et Depression
Cross
al(2014) Community Scale, ≥13 4-5 months 1823 27.37%
sectional
China Hamilton
Depression
Scale and
Social Support
Rating Scale.
World Health
Organization
haixin Bo et antenatal period
Multicenter Cross Quality of Life
al(2020) ≥13 and 1 week 1060 7.45%
Hospital - 8 sectional Questionnaire,
China postpartum
EPDS(Chinese
version)

ISSN No:-2456-2165

Setting Tools
prospecti
18.37%, 15.19%,
Irma Nurbaeti et ve 1,2 and 3
and 26.15% at one,
al(2018) Hospital longitudi EPDS ≥13 months 283
two and three
Indonesia nal study postpartum
months
design
Ayse Figen
Turkcapar et Cross
al(2015) sectional
Turkey
R. Abdul
Prospecti 36 weeks ,1 and
Raheem et 27% at 1 month and
Hospital ve cohort EPDS ≥13 3 months 458
al(2018) 12% at 3 months
study postpartum
Maldives
J.R.W. Fisher et
Cross 6 weeks
al(2004) Hospital EPDS >12 506 166(33%)
Vietnam
Irandokht Asadi
Beck
Sadeghi Azar et Cross
Hospital Depression ≥17 2-8 weeks 408 40.40%
al(2012) sectional
Inventory
Zabol,Iran)
Pegah Taherifard
Cross
et al(2013) Hospital EPDS ≥13 197
sectional
Ilam,Iran
Fatma Ibrahim 13.5% at 2

longitudi 2 and 8 weeks
Al Hinai(2014) Community EPDS(Arabic) 282 weeks,10.5% at 8
nal study postpartum
Oman weeks
≥13
Benjaporn EPDS(Thai)
Panyayong et Cross Self- 6 and 8 weeks
Hospital 1731 8.40%
al(2013) sectional administered postpartum
Thailand Q ≥13
Cross 8 weeks
Hospital EPDS >13 1200 36.30%
Maryam Rouhi et sectional postpartum
al(2012)Azerbaij
an,Iran
VI. RISK FACTORS ASSOCIATED WITH aspects that form a part of the SES are mentioned Financial
POSTPARTUM DEPRESSION Dependence ,Low income, low family income, low asset
ownership, annual household income, economic deprivation
The risk factors associated with PPD were classified and poverty. The second major risk factor associated with
under five different categories. They are 1.Socio- PPD is the Age reported in 19 studies.2 studies conducted in
demographic variables,2.Pregnancy and Birth Related Iran (Zabol and Azerbaijan) revealed that the younger
Variables,3.Infant Variables,4.Family Relationships and marital age is associated with PPD. In a study conducted in
Psychosocial factors.Please refere Table 3 showing the UAE , higher marital age is associated with PPD.2 studies
factors identified to be associated with Postpartum conducted in India(Kerala and Delhi),India observed that
Depression. getting married at young age is a risk factor associated with
PPD. To the contrary, a study conducted in Jharkhand &
1.Socio-demographic Variables Orissa revealed that higher maternal age was associated with
The most prominent variable associated with PPD Low PPD. Level of Education was a risk factor in 6 studies. In a
Income or Socio-Economic Status (SES). It has been study conducted in Karnataka ,India it is observed that
reported that 22 studies indicate that the low income or SES higher level of education has been associated with PPD. In 1
contributes majorly as a risk factor to PPD. The various study conducted in Tamil Nadu, illiteracy was a contributing

ISSN No:-2456-2165
factor to PPD.4 studies conducted in Iran, Pakisthan , Syria relationship issues with mother-in-law.10 studies revealed
and Kuwait indicated that low level of Education is that the lack of support from husband and being unable to
associated with PPD. In a study conducted in Gujarat,the confide in partner as a strongest predictors associated with
marital status(Single) is found to be a risk factor associated PPD.7 studies indicated that difficulties with mother-in-law
with PPD. (1 Tamil nadu,1 Gujarat,1 Kerala,1 China,1 Zabol,1 UAE)
were strongly associated with PPD.4 Studies revealed that
2. Pregnancy & Birth Related Variables Marital disharmony-1 Tamil Nadu,1 Goa,1 Indonesia,1
The prominently associated pregnancy and birth Thailand to be associated with PPD.5 Studies in Tamil
related variables associated with PPD were Nadu, Pondicherry, Kerala, Sudan, Pakisthan reported that
Unplanned/Unwanted Pregnancy, Obstetric Complications domestic violence and addiction in husband as a predictor
during Pregnancy, Mode of Delivery and Parity. In 5 studies for PPD.
conducted in Nepal, Pondicherry, Gujarat and Karnataka it
is observed that multiparity is associated with PPD. In one 6.Maternity Care Related Factors
study conducted in UAE and 1 study conducted in Delhi, Mohammad et al. investigated the factors related to the
Primiparity was associated with PPD.3 study in Karnataka,1 maternity care of during labor and birth and their
study conducted in Gujarat and 1 study conducted in associations with PPD. Factors found to be significantly
Jharkhand, it was found that the Obstetric complications in associated with PPD at 6-8 weeks postpartum were: duration
the antepartum period/during labour were associated with of labor exceeding 11 hours; more than 8 vaginal exams;
PPD. Unwanted/Unplanned pregnancy was associated with lying in lithotomy position during labor; episiotomy or
PPD in 6 studies conducted in Saudi Arabia, Pakistan, painful suturing; labor more painful than expected;
Vietnam, Laos, Kuwait and Iran. It is also observed that out dissatisfaction with pain relief measures during labor;
of 33 studies conducted in India none have reported that postpartum haemorrhage; overall poor quality of care;
Unplanned/unwanted pregnancy has an association with unhelpful doctors; mother’s desire to talk more about birth;
PPD.3 studies conducted in Srilanka, Jordan and China mother not always kept informed; decisions were made
reported that the mode of delivery as a variable associated without taking mother’s wishes into account; mother felt
with PPD.3 studies conducted in Delhi, Andhra Pradesh and pressured to have baby quickly;doctors and midwives were
Jharkhand found mode of delivery to be associated with not encouraging nor reassuring; mothers wanted more
PPD.A study conducted in Andhra Pradesh reported that information during labor; mothers wanted more information
PPD was associated with previous miscarriages and who are about why induction was necessary; mother felt worried,
having abnormalities in the previous child in the case of anxious or frightened when labor began; mother did not feel
consanguineous marriage. confident in labor; mother was not composed but was
frightened or helplessness. Chung et al. reported that women
3. Infant Variables who showed a significant degree of depression in the third
Factors that are closely associated with the infant trimester of pregnancy had an increased risk for the need of
variable are Preference for baby boy, issues related to Infant epidural anesthesia, cesarean section, or instrument-assisted
Feeding and Low birth weight of the Infant.7 studies in vaginal birth during childbirth compared with less depressed
India reported that there was a preference for baby boy or non-depressed mothers.
(2studies in Tamil Nadu,1 Karnataka,2 studies in Gujarat,1
study in Madhya Pradesh,1 study in Maharashtra). It is also 7.Psychosocial factors
observed that only 2 studies in Indonesia and Pakisthan in Twelve studies indicated that stressful life events have
the other Asian countries apart from India,the preference for been a major trigger associated with PPD.10 studies
a baby boy was not found to be associated with PPD. This revealed that past history of psychiatric illness is associated
shows that there is a strong preference for baby boy in some with PPD.5 studies tells us that lack of physical support
places of India.Infant feeding related issues like difficulty to (absence of care giver apart from mother) and 5 studies
breastfeed, completely no breastfeeding, formula feeding reveal that lack of social support are associated to the
and frequent feeding were significant risk factors associated presence of PPD.8 Studies have revealed that Antenatal
with PPD.5 Studies conducted in Pakisthan, Indonesia,UAE, depression,anxiety and stress to be strongly associated with
Kuwait reported Infant feeding.4 studies conducted in PPD.According to Biaggi et al. the most relevant factors
Gujarat, Jharkhand ,Kerala and Laos reported low birth associated with antenatal depression or anxiety were the lack
weight as a risk factor associated with PPD. of social support from the partner; history of domestic
abuse/violence; personal history of mental illness;
4. Marital & Family Relationship Variables unplanned or unwanted pregnancy; adverse life events and
The most important variables associated with PPD are high levels of perceived stress; complications in pregnancy
Lack of support from husband, marital disharmony and in the past/present and pregnancy loss.

ISSN No:-2456-2165
Table 3 showing the factors identified to be associated with Postpartum Depression
Category Variable Number of Studies Associated factor
Age 19 Young marital age,High marital age
Education 6 Illetracy,higher education
Financial Dependence,Low income,low
Socio- family income,low asset ownership,annual
demographic hpousehold income,Economic
Variables Income /Socio-economic deprivation,poverty,housing
Status(SES) 22 condition,unemployment
Access to transportation 2
Access to maternal health care
facilities 2
Parity 4 Primiparous,multiparity
Obstetric Complications during
Pregnancy 6 High risk pregnancy,multigravida
Pregnancy & Birth Mode of Delivery 8
Related Variables Poor antenatal care 1
Previous Miscarriages 2
Abnormalities in previous child 1
Unplanned/Unwanted Pregnancy 6
Infant health issues 6
No breastfeeding,difficulty in
Infant Feeding 5 breastfeeding,mixed feeding,frequent feeding
Infant Variables
Low birth weight of the Infant 5
Preference for boy baby 10
Still Birth/Neonatal death 2
Relationship difficulties with
mother-in-law 8
Self 1 low self esteem,body image,increased weight
Marital & Family Marital Disharmony 8
Relationship
Domestic Violence 7 Addiction in husband
Variables
Lack of support from husband 12
Family Structure 2 Nuclear family,joint family,single mother
Type of Marriage 1
Stressful life events 12
Lack of support apart from mother,child care
Lack of Physical support 5 stress
Antenatal Depression,Anxiety & Mood swings,low mood during
Stress 8 pregnancy,sleep disturbances
Psychosocial Family history of Psychiatric illness,history
Variables Past history of psychiatric Illness 10 of pms
Physical Co-morbiodity 2
Suicidal Ideation 3
Low social support 5
Major financial problems 1
VII. DISCUSSION The strongest socio-demographic risk factor associated with

PPD is low income or low socio-economic status. The
To the best of our knowledge this review is very related variables associated with this factor were financial
comprehensive in terms of studying Postpartum Depression Dependence, Low income, low family income, low asset
and the associated risk factors in Indian and other Asian ownership, annual household income, Economic
mothers in the time period 2000-2020.This study reviewed deprivation, poverty, housing condition, unemployment. The
31 studies conducted in India and 27 studies from other perception of mothers towards the mode of delivery on a
Asian countries. In this review studies have been included broader view did not seem to have a high association with
that have a cross sectional or longitudinal research design. PPD. However in a study at Delhi women who underwent

ISSN No:-2456-2165
C-section suffered more (21.05%) when compared to mothers who delivered baby boy son is considered desirable
women who underwent vaginal birth (12.9%)(32) .It was and traditionally receive more social support.
interesting to note that in Lebanon, women who lived in the
Beka valley were pleased to be delivered vaginally whereas Contrary to the common perception that education
women residing in Beirut had the perspective that vaginal leads to the empowerment and there by reduction in
delivery is a source of fear, pain, and stress compared with postnatal depression, in the study conducted by A. Agarwala
caesarean section. This perspective is also influenced by the et al. It was observed that level of education; could be a risk
pace of life and the higher level of educated population in factor associated with postpartum depression. It showed that
Beirut, the capital city(57). higher level of education of the mothers increased the
possibilities of developing PPD. This could be possibly due
It is important to note that many mothers continue to to the fact that educated women were more involved in their
be hesitant to express their depressive symptoms and reach career and had challenges in less managing baby, career and
out to mental health professionals. In the study of Chandran household work.Work related stress can also be a strong
et al, none of the mothers had sought help for their factor leading to depression(19). In contrast to this study,
symptoms, although many were functionally impaired and low educational status was found to be a risk factor for
were barely coping with their responsibilities. One possible postpartum depression by Gupta et al. in Delhi. In that study
reason for the health services to be less utilized could be the it was attributed those women with low educational status
belief held by mothers, family members and even the area were not able to think logically and were unable to take
health workers that this state is a normal part of pregnancy decision both emotionally and economically.
and the post-partum period.According to Shriraam, et al.,
most women with depression (92.5%) did not seek any form Role of the Government in supporting Mothers in the
of health care. (9). postpartum period
There is a significant role of the Government and its
Another critical support that is required during the policies that can contribute to the enhancement of the
postpartum phase is emotional support especially for women maternal and infant wellbeing in the postpartum period.
who have experienced complicated pregnancies and had still Omani women receive great support from the government in
births. In the study conducted by Shriraam, et al. among two education, job opportunities, civil service and social
women who had still birth, one woman was depressed and insurance. In addition, mothers receive support during the
the other woman delivered twins and one baby was alive. first 40 days from their families and possibly housemaids
She expressed her views that receiving strong emotional which helps to lower the stress of being a new mother(63).
support from her mother-in-law because of which she could In Indonesia, currently family do not need to pay money for
overcome the death of her child without going into delivery because the birth process in Indonesia is covered by
depression(9). It was interesting to note that in the study government national health insurance. Although India is
conducted by Avita Rose Johnson et al that the antenatal implementing a cash-transfer scheme that pays Rs 1,400 to
mothers residing with the family of birth during pregnancy women delivering in government institutions, the findings of
as opposed to with the husband, was related to postnatal study suggest that women need financial support to meet
depression (18). Staying with the husband during pregnancy their own and their infants’ health needs in the postpartum
could help the mother receive more support from the year (36).
husband and could reduce the level of postnatal depression.
This reiterates that fact that family support is of significant In collaboration with the Programme for Improving
importance for postpartum women in combating depression. Mental Health Care (PRIME) research consortium, the
As a new mother and home maker, the mother will also Madhya Pradesh state government started integrating mental
require physical support to resume household work. Kirti health care services for depression into the primary health
Iyengar et al in her study mentioned that most common care sector, which includes perinatal health services, in
challenge was to resume household work (defined as Sehore District in 2013 (29). In 2016, nurses in district
inability to do household work or doing it with difficulty). hospitals across the state received training to screen and
At 6-8 weeks, a larger proportion of women with severe and detect perinatal depression and provide basic psychological
less-severe complications reported difficulty in resuming interventions.(27).The growing number of suicides as a
their household work (37). major contributor to maternal mortality in Kerala has been
identified in a confidential review of maternal deaths in
In India preference to male child is deeply ingrained. Kerala. The program 'Amma Manassu' implemented by the
In Indian culture, girl goes to her husband’s house after Department of Health and Family Welfare in Kerala mainly
marriage, changes her last name to husband’s last name and focussed and aimed at reducing the maternal deaths due to
expected to adapt and follow his family lineage. Whereas suicide(12).
the male stays with his parents till death and he will
continue their family pedigree, support parents in their old VIII. LIMITATIONS
age, perform funeral rites and inherit ancestral property.
Birth of baby girl is considered stressor many families in One of the major limitations is employing a cross
Indian societies and hence could be a strong predictor of sectional study design. The major shortcoming in a single
postnatal depression. According to the Jordanian cultural time point evaluation in the postpartum period is over
and traditional practices and Arabic Muslim societies, estimating the prevalence as there is exclusion of cases that

ISSN No:-2456-2165
may have also pre-existing depression in the antenatal establish whether any change in depressive symptoms
period which does not necessarily classify as postpartum associated with unmet gender preference is still persistent.
depression. (33). Owing to the small sample size, it is
difficult to replicate to the general population. Factors such REFERENCES
as domestic violence, marital disharmony and lack of social
support are also well-established risk factors for postpartum [1]. Stewart DE, Robertson E, Dennis CL, Grace SL,
depression in mothers. However, to reduce nonresponse, Wallington T. Postpartum depression: literature review
social support was used as a proxy for the other variables in of risk factors and interventions. Toronto: University
some studies which is viewed as a limitation of this study. Health Network Women’s Health Program; 2003.
Another important limitation is the reliance on a self- [2]. Di Florio A, Smith S, Jones I. Postpartum psychosis.
reported depression screening tool rather than clinician The Obstetrician & Gynaecologist. 2013;15(3):145–
diagnosis. Although the EPDS has been validated among a 50. doi: http://dx.doi.org/10.1111/tog.12041
broad range of populations, cultural and economic factors [3]. O’hara MW, Swain AM. Rates and risk of postpartum
may have caused women to over-report or under-report depression –a meta-analysis. Int Rev Psychiatry.
depressive symptoms. (62). Women with abortion or 1996;8(1):37–54. doi: http://dx.doi.
stillbirth failed to come for follow up during the study org/10.3109/09540269609037816
period. Therefore, the association with postpartum [4]. Surkan PJ, Kennedy CE, Hurley KM, Black MM.
depression could not be studied. (17) Maternal depression and early childhood growth in
developing countries: systematic review and meta-
IX. IMPLICATIONS FOR CLINICAL PRACTICE analysis. Bull World Health Organ. 2011 Aug
1;89(8):608–15D.
There is a paucity of research in developing countries [5]. The World Health Report 2005. Make Every Mother
addressing the impact of post-partum depression on the and Child Count. Chapter. 4. Attending to 136 Million
cognitive, emotional and physical development of infants Births, Every Year. p. 61-77. Available from:
born to mothers with postnatal distress. Research aimed at http://www.who.int/whr/2005/chap4-en. pdf.
measures to prevent post-partum depression and to elucidate [6]. Baron EC, Hanlon C, Mall S, Honikman S, Breuer E,
what treatments work best – and are practical in low-income Kathree T, et al. Maternal mental health in primary
countries – is also urgently required. (8). The studies care in five low- and middle-income countries: a
reiterate the fact that Maternal mental health awareness situational analysis. BMC Health Serv Res. 2016 02
programs about PPD and encouraging breastfeeding should 16;16(1):53. doi: http:// dx.doi.org/10.1186/s12913-
be implemented in the antenatal and postnatal periods to 016-1291-z PMID: 26880075
help early detection and reduction of PPD among women. [7]. Gibson, Jessica & McKenzie-McHarg, Kirstie &
Frequent screening for maternal distress in the last trimester Shakespeare, Judy & Price, Jonathan & Gray, Ron.
of pregnancy and in the post-partum period needs to be (2009). A systemic review of studies validating the
carried out by health care workers when mothers come for Edinburgh Postnatal Depression Scale in antepartum
their postnatal review or at the immunization clinics. and postpartum women. Acta psychiatrica
Mothers with high symptoms have to be directed to receive Scandinavica. 119. 350-64. 10.1111/j.1600-
guidance from a psychiatrist for further assessment. 0447.2009.01363.x.
[8]. Chandran, M., Tharyan, P., Muliyil, J., & Abraham, S.
X. CONCLUSION (2002). Post-partum depression in a cohort of women
from a rural area of Tamil Nadu, India. Incidence and
From the studies performed so far it is very evident risk factors. The British journal of psychiatry : the
that further research in the field of maternal mental health is journal of mental science, 181, 499–504.
not only required to reiterate the burden of the problem in https://doi.org/10.1192/bjp.181.6.499
developing and developed countries, but also to help the [9]. Shriraam V, Shah PB, Rani MA, Sathiyasekaran B. A
Government to formulate policies and programs that would community-based study of postpartum depression in
exclusively cater to Maternal mental health and Infant rural Southern India. Indian J Soc Psychiatry
Wellbeing. In order to generalise the results to the 2019;35:64-8.
population, it is recommended to have larger sample size [10]. Dr. Latha Venkatesan,Dr. Vijayalakshmi K ,Ms. Priya
involving heterogeneous population. Another step to aid the S. RISK FACTORS OF POSTPARTUM
generalisation will be to conduct a greater number of DEPRESSION AMONG THE POSTNATAL
community-based studies involving people from different MOTHERS .University Journal of Nursing Sciences
geographic location and varied socio-economic status. It is 2017, Vol.1 (1)
also to be noted that a longitudinal study design will give the [11]. Poomalar GK, Bupathy A. Impact of socio-cultural
researcher more clarity and perspective to understand the factors on postpartum depression in South Indian
prevalence and associated risk factors in a phased manner women. Int J Reprod Contracept Obstet Gynecol
and assess the progress accordingly. Another important 2014;3:338-43.
recommendation is to assess the gender preferences prior to [12]. Santhosh K, Dayal Narayan KTP, Vinaychandran S,
giving birth and screen women for depression at the time of Mini CH. Postpartum depression and its association
gender reveal (at birth, legally, in India), and should with social support: a cross sectional study at a

ISSN No:-2456-2165
maternity hospital in Kerala. Kerala Journal of [24]. Modi VP, Parikh MN, Valipay SK. Prevalence of
Psychiatry 2020, 33(2): postpartum depression and correlation with risk
[13]. Shenoy HT, Remash K, Shenoy ST. Prevalence and factors. Ann Indian Psychiatry 2018;2:27-32.
determinants of postnatal depression in a tertiary care [25]. Dr. Darshana Hirani1 , Dr. D. V. Bala 2. A Study of
teaching institute in Kerala, India. Int J Reprod Postnatal Depression and Its Determinants in Postnatal
Contracept Obstet Gynecol 2019;8:3757-64. Women Residing In Rural Areas of Ahemdabad
[14]. Ch. Beaula Rani and Latha P. A study to determine the District, Gujarat, India. IOSR Journal of Dental and
prevalence of postpartum depression among postnatal Medical Sciences (IOSR-JDMS). e-ISSN: 2279-0853,
mothers at Venkatachalam village, Nellore, Andhra p-ISSN: 2279-0861.Volume 14, Issue 7 Ver. VII (July.
Pradesh. International Journal of Obstetrics and 2015), PP 10-15
Gynaecological Nursing 2019; 1(1): 13-15 [26]. Patel, V., Rodrigues, M., & DeSouza, N. (2002).
[15]. P. Latha. Level of post-partum depression among Gender, poverty, and postnatal depression: a study of
LSCS mothers at government area hospital, mothers in Goa, India. The American journal of
Bhadrachalam, Telangana. International Journal of psychiatry, 159(1), 43–47.
Applied Research 2016; 2(4): 444-446. https://doi.org/10.1176/appi.ajp.159.1.43
[16]. Lakshmi Bhuvana G1 , Ramam Sripada2* , Devi Priya [27]. Rathod, Sujit & Honikman, Simone & Hanlon,
S, B B P Raja Sanjay1 , Satya Rajeswari K1 , Rama Charlotte & Shidhaye, Rahul. (2018). Characteristics
Chandran S. Prevalence of Postpartum Depression at of perinatal depression in rural central, India: a cross-
an Indian Tertiary Care Teaching Hospital. sectional study. International Journal of Mental Health
International Journal of Pharmaceutical and Clinical Systems. 12. 10.1186/s13033-018-0248-5.
Research 2016; 8(6): 616-618. [28]. Guin G, Rawat S. Prevalence of postpartum depression
[17]. Shivalli S, Gururaj N (2015) Postnatal Depression and association with risk factors in a tertiary care
among Rural Women in South India: Do Socio- hospital. Int J Reprod Contracept Obstet Gynecol
Demographic, Obstetric and Pregnancy Outcome Have 2018;7:1094-100.
a Role to Play? PLoS ONE 10(4): e0122079. [29]. Shidhaye, R., Baron, E., Murhar, V., Rathod, S., Khan,
doi:10.1371/journal.pone.0122079 A., Singh, A., Shrivastava, S., Muke, S., Shrivastava,
[18]. Johnson, Avita & Edwin, Serin & Joachim, R., Lund, C., & Patel, V. (2019). Community, facility
Nayanthara & Mathew, Geethu & Ajay, Shweta & and individual level impact of integrating mental
Joseph, Bobby. (2015). Postnatal Depression among health screening and treatment into the primary
women availing maternal health services in a rural healthcare system in Sehore district, Madhya Pradesh,
hospital in South India. Pakistan Journal of Medical India. BMJ global health, 4(3), e001344.
Sciences. 31. 10.12669/pjms.312.6702. https://doi.org/10.1136/bmjgh-2018-001344
[19]. Anamika Agarwala, P. Arathi Rao , Prakash [30]. Sidhpura, Dhwani & Pimpale, Satish & Kumar, Ajay.
Narayanan. Prevalence and predictors of postpartum (2018). COMPARISON OF POST-NATAL
depression among mothers in the rural areas of Udupi DEPRESSION AMONG WOMEN OF UPPER,
Taluk, Karnataka, India: A cross-sectional study. MIDDLE AND LOWER SOCIOECONOMIC
Clinical Epidemiology and Global Health 7 (2019) STATUS. International Journal of Physiotherapy and
342–345 Research. 6. 2643-2647. 10.16965/ijpr.2018.105.
[20]. Sankapithilu GJ, Nagaraj AKM, Bhat SU, Raveesh [31]. Basu, S., Budh, N., Garg, S., Singh, M. M., & Sharma,
BN, Nagaraja V. A comparative study of frequency of A. (2019). Postpartum depression burden and
postnatal depression among subjects with normal and associated factors in mothers of infants at an urban
caesarean deliveries. Online J Health Allied Scs. primary health center in Delhi, India. Tzu chi medical
2010;9(2):4 journal, 33(1), 70–73.
[21]. Suguna A, Naveen R, Surekha A. Postnatal Depression https://doi.org/10.4103/tcmj.tcmj_190_19
among Women Attending A Rural Maternity Hospital [32]. Srivastava AS, Mara B, Pandey S, Tripathi MN, Pandit
in South India. Ntl J of Community Med 2015; B, Yadav JS. Psychiatric morbidities in postpartum
6(3):297- 301. females: a prospective follow-up during puerperium.
[22]. Desai Nimisha D1, Mehta Ritambhara Y2, Ganjiwale Open J Psychiatry Allied Sci. 2015;6:101-5. doi:
Jaishree. STUDY OF PREVALENCE AND RISK 10.5958/2394-2061.2015.00005.1
FACTORS OF POSTPARTUM DEPRESSION. [33]. Kamal, Dr & Kalita, Kamal. (2010). Developmental
NATIONAL JOURNAL OF MEDICAL Profile of Infants Born to Mothers with Postpartum
RESEARCH.Volume 2 Issue 2 Apr – June 2012 print Depression and Anxiety: A Comparative Study. J.
ISSN: 2249 4995 eISSN: 2277 8810 Indian Assoc. Child Adolesc. Ment. Health. 6. 3-12.
[23]. Himadri L. Patel,1 Jaishree D. Ganjiwale,2 Archana S. Shrestha et al.INCIDENCE AND PREVALENCE OF
Nimbalkar,3 Shashi N. Vani,1 Rohitkumar Vasa,4 and POSTPARTUM DEPRESSION IN A RURAL
Somashekhar M. Nimbalkar. Characteristics of COMMUNITY OF INDIA. Journal of Chitwan
Postpartum Depression in Anand District, Gujarat, Medical College 2015; 5(12
India. Journal of Tropical Pediatrics, 2015, 61, 364– [34]. Arju Chand Singh., et al. “Prevalence and Associated
369 Factors in Postpartum Depression at Tertiary Hospital
in Nepal”. Acta Scientific Women's Health 2.1 (2020):
23-28

ISSN No:-2456-2165
[35]. Signe Dørheim Ho-Yen, Gunnar Tschudi Bondevik, [46]. Bo, Haixin & YANG, YUAN & Zhang, Dongying &
Malin Eberhard-Gran & Bjørn Bjorvatn (2007) Factors Zhang, Meng & Wang, Peihong & Liu, Xiaohua & Ge,
associated with depressive symptoms among postnatal Lina & Lin, Wenxuan & Xu, Yang & Zhang, Yalan &
women in Nepal, Acta Obstetricia et Gynecologica Li, Fengjuan & Xu, Xujuan & Wu, Honghe & Jackson,
Scandinavica, 86:3, 291- Todd & Ungvari, Gabor & Cheung, Teris & Xiang,
297, DOI: 10.1080/00016340601110812 Yu-Tao. (2020). The prevalence of depression and its
[36]. Iyengar, Kirti & Yadav, Ranjana & Sen, Swapnaleen. association with quality of life among pregnant and
(2012). Consequences of Maternal Complications in postnatal women in China: a multicenter study.
Women’s Lives in the First Postpartum Year: A 10.21203/rs.3.rs-87042/v1.
Prospective Cohort Study. Journal of health, [47]. Turkcapar, A. F., Kadıoğlu, N., Aslan, E., Tunc, S.,
population, and nutrition. 30. 226-40. Zayıfoğlu, M., & Mollamahmutoğlu, L. (2015).
10.3329/jhpn.v30i2.11318. Sociodemographic and clinical features of postpartum
[37]. Prost A, Lakshminarayana R, Nair N, Tripathy P, depression among Turkish women: a prospective
Copas A, Mahapatra R, Rath S, Gope RK, Rath S, study. BMC pregnancy and childbirth, 15, 108.
Bajpai A, Patel V, Costello A. Predictors of maternal https://doi.org/10.1186/s12884-015-0532-1
psychological distress in rural India: a cross-sectional [48]. R. Abdul Raheem, MPH, PhD1, Hui J. Chih, PhD2,
community-based study. J Affect Disord. 2012 and Colin W. Binns, MBBS, PhD. Factors Associated
May;138(3):277-86. doi: 10.1016/j.jad.2012.01.029. With Maternal Depression in the Maldives: A
[38]. Fan, Qiping & Long, Qian & De Silva, Vijitha & Prospective Cohort Study. Asia Pacific Journal of
Gunarathna, Nishan & Jayathilaka, Upul & Dabrera, Public Health 2018, Vol. 30(3) 244–251
Thushani & Lynn, Henry & Østbye, Truls. (2019). [49]. Fisher, J. R., Morrow, M. M., Ngoc, N. T., & Anh, L.
Prevalence and Risk Factors for Postpartum T. (2004). Prevalence, nature, severity and correlates
Depression in Sri Lanka: A Population-Based Study. of postpartum depressive symptoms in Vietnam. BJOG
Asian Journal of Psychiatry. 47. 101855. : an international journal of obstetrics and
10.1016/j.ajp.2019.101855. gynaecology, 111(12), 1353–1360.
[39]. Al Nasr RS, Altharwi K, Derbah MS, Gharibo SO, https://doi.org/10.1111/j.1471-0528.2004.00394.x
Fallatah SA, Alotaibi SG, et al. (2020) Prevalence and [50]. Azar, Sadeghi & Hashemi Bonjar, Zohreh & Forghani,
predictors of postpartum depression in Riyadh, Saudi & Asadi, Irandokht & Hashemi, Zohrehsadat &
Arabia: A cross sectional study. PLoS ONE 15(2): Forghani, Forugh. (2006). Postpartum Depression and
e0228666. its Correlates among Women Living in Zabol (Iran).
https://doi.org/10.1371/journal.pone.0228666 Iranian Journal of Psychiatry. 1.
[40]. Khalifa, Dina & Glavin, Kari & Bjertness, Espen & [51]. Taherifard, P., Delpisheh, A., Shirali, R.,
Lien, Lars. (2016). Determinants of postnatal Afkhamzadeh, A., & Veisani, Y. (2013).
depression in Sudanese women at 3 months Socioeconomic, psychiatric and materiality
postpartum: A cross-sectional study. BMJ Open. 6. determinants and risk of postpartum depression in
e009443. 10.1136/bmjopen-2015-009443. border city of ilam, Western iran. Depression research
[41]. Tashakori A, Shanesaz A, Rezapour A. Assessment of and treatment, 2013, 653471.
some potential risk factors of postpartum depression. https://doi.org/10.1155/2013/653471
Pak J Med Sci 2009;25(2):261-264. [52]. Al Dallal, F. H., & Grant, I. N. (2012). Postnatal
[42]. Ali et al.: Impact of postpartum anxiety and depression depression among Bahraini women: prevalence of
on child’s mental development from two peri-urban symptoms and psychosocial risk factors. Eastern
communities of Karachi, Pakistan: a quasi- Mediterranean health journal = La revue de sante de
experimental study. BMC Psychiatry 2013 13:274 la Mediterranee orientale = al-Majallah al-sihhiyah
[43]. Rahman, Atif & Creed, Francis. (2007). Outcome of li-sharq al-mutawassit, 18(5), 439–445.
prenatal depression and risk factors associated with [53]. Moraitou, Martha & Michalis, Galanakis & Esmeralda,
persistence in the first postnatal year: Prospective Lamai & Garivaldis, Filia & Valedina, Kalogianni.
study from Rawalpindi, Pakistan. Journal of affective (2010). Postpartum depression in Cypriot New
disorders. 100. 115-21. 10.1016/j.jad.2006.10.004. Mothers. International Journal of Caring Sciences. 3.
[44]. Yehia, Dalal & Callister, Lynn & Hamdan- Mansour, [54]. Chaaya, Monique & Campbell, Oona & El-Kak,
Ayman. (2013). Prevalence and Predictors of Faysal & Shaar, D & Harb, Hilda & Kaddour, Afamia.
Postpartum Depression Among Arabic Muslim (2002). Postpartum depression: Prevalence and
Jordanian Women Serving in the Military. The Journal determinants in Lebanon. Archives of women's mental
of perinatal & neonatal nursing. 27. 25-33. health. 5. 65-72. 10.1007/s00737-002-0140-8.
10.1097/JPN.0b013e31827ed6db. [55]. Inthaphatha, S., Yamamoto, E., Louangpradith, V.,
[45]. Deng, A. W., Xiong, R. B., Jiang, T. T., Luo, Y. P., & Takahashi, Y., Phengsavanh, A., Kariya, T., Saw, Y.
Chen, W. Z. (2014). Prevalence and risk factors of M., & Hamajima, N. (2020). Factors associated with
postpartum depression in a population-based sample of postpartum depression among women in Vientiane
women in Tangxia Community, Guangzhou. Asian Capital, Lao People's Democratic Republic: A cross-
Pacific journal of tropical medicine, 7(3), 244–249. sectional study. PloS one, 15(12), e0243463.
https://doi.org/10.1016/S1995-7645(14)60030-4 https://doi.org/10.1371/journal.pone.0243463

ISSN No:-2456-2165
[56]. Roumieh, M., Bashour, H., Kharouf, M., & Chaikha,
S. (2019). Prevalence and risk factors for postpartum
depression among women seen at Primary Health Care
Centres in Damascus. BMC pregnancy and
childbirth, 19(1), 519. https://doi.org/10.1186/s12884-
019-2685-9
[57]. Green, K., Broome, H., & Mirabella, J. (2006).
Postnatal depression among mothers in the United
Arab Emirates: socio-cultural and physical
factors. Psychology, health & medicine, 11(4), 425–
431. https://doi.org/10.1080/13548500600678164
[58]. Panyayong B. (2013). Postpartum depression among
Thai women: a national survey. Journal of the Medical
Association of Thailand = Chotmaihet
thangphaet, 96(7), 761–767.
[59]. Maita H, Kobayashi T, Osawa H, et al. Postpartum
depression and health related quality of life: a
necessary assessment. Int J Fam Commun Med.
2017;1(1):11-17. DOI: 10.15406/ijfcm.2017.01.00005
[60]. Rouhi, Maryam & Yousefi, Homa & Hasan, Masumeh
& Vizheh, Maryam. (2012). Ethnicity as a risk factor
for postpartum depression. British Journal of
Midwifery. 20. 419-426.
10.12968/bjom.2012.20.6.419.
[61]. 61.Al Hinai, F. I., & Al Hinai, S. S. (2014).
Prospective study on prevalence and risk factors of
postpartum depression in Al-dakhliya governorate in
oman. Oman medical journal, 29(3), 198–202.
https://doi.org/10.5001/omj.2014.49

A Systematic Review On The Prevalence of Postpartum Depression and The Associated Risk Factors in Asia

Uploaded by

Copyright:

Available Formats

A Systematic Review On The Prevalence of Postpartum Depression and The Associated Risk Factors in Asia

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

A Systematic Review On The Prevalence of Postpartum Depression and The Associated Risk Factors in Asia

Uploaded by

Copyright:

Available Formats

Volume 6, Issue 7, July – 2021 International Journal of Innovative Science and Research Technology

A Systematic Review on the Prevalence of

Abstract:- Keywords:- “Postpartum” or “Postnatal” or

IJISRT21JUL376 www.ijisrt.com 363

II. OBJECTIVES & FEATURES IV. RESULTS

IJISRT21JUL376 www.ijisrt.com 364

IJISRT21JUL376 www.ijisrt.com 365

IJISRT21JUL376 www.ijisrt.com 366

Author and Research Cut off Data collection No of No of mothers with

IJISRT21JUL376 www.ijisrt.com 367

Author and Research Cut off Data collection No of No of mothers with

IJISRT21JUL376 www.ijisrt.com 368

Author and Research Cut off Data collection No of No of mothers with

SIGNE Hospital and Cross

Arju Chand Cross

IJISRT21JUL376 www.ijisrt.com 369

Author and Research Cut off Data collection No of No of mothers with

IJISRT21JUL376 www.ijisrt.com 370

Author and Research Cut off Data collection No of No of mothers with

Fatma Ibrahim 13.5% at 2

IJISRT21JUL376 www.ijisrt.com 371

IJISRT21JUL376 www.ijisrt.com 372

VII. DISCUSSION The strongest socio-demographic risk factor associated with

IJISRT21JUL376 www.ijisrt.com 373

IJISRT21JUL376 www.ijisrt.com 374

IJISRT21JUL376 www.ijisrt.com 375

IJISRT21JUL376 www.ijisrt.com 376

IJISRT21JUL376 www.ijisrt.com 377

IJISRT21JUL376 www.ijisrt.com 378

You might also like