scholarly journals A Systematic Review and Meta-Analysis of Depression in Postnatal Women in the Case of a Low-Income Country; Ethiopia, 2020

2020 ◽  
Author(s):  
Mogesie Necho ◽  
Merid Abadisharew

Abstract BackgroundMaternal mental health in the postpartum period is essential for the optimal development of the newborn and appropriate breastfeeding practices. Despite this, a shortage of concrete evidence exists regarding the magnitude of postpartum depression and associated factors. This meta-analysis study was therefore done to fill such a gap.MethodsPubMed, Scopus, and EMBASE were investigated with no time limitation. A manual search for a reference list of articles was also done. Relevant data were extracted using Meta XL package and analysis was done Stata-11 meta-prop package. Heterogeneity was checked with Cochran's Q-statistics and the Higgs I2 test. Furthermore, sub-group and sensitivity analyses were done. Egger's test and funnel plots tests were engaged to identify publication bias.ResultsA total of 16 studies that assessed 11400 postpartum women in Ethiopia were included. The average estimated prevalence of postpartum depression was 21.9% (95% CI: 18.98, 24.77). The pooled prevalence of postpartum depression was higher in studies that used SRQ-20; 24.6% (95% CI: 18.42, 30.84) than studies that used PHQ-9; 18.9% (95% CI: 11.52, 26.28). Moreover, the pooled estimated prevalence of postpartum depression was slightly higher in the southern part of Ethiopia (22.6%) than Addis Ababa (21.2%). Poor marital relation (pooled aOR = 3.56) (95% CI: 2.50, 4.63), unplanned pregnancy (pooled aOR = 3.48) (95% CI: 2.18, 4.79), previous history of depression (pooled aOR = 4.33) (95% CI: 2.26, 6.59), poor social support (pooled aOR = 4.5) (95% CI: 3.34, 5.56), domestic violence (pooled aOR = 3.77) (95% CI: 2.62, 4.92), family history of mental illness (pooled aOR = 4) (95% CI:1.56, 6.56), use of substance (pooled aOR = 4.67) (95% CI:4.00, 5.34), low income (pooled aOR = 2.87) (95% CI: 1.59, 4.14), stressful life event (pooled aOR = 3.5) (95% CI: 1.39, 5.87) and perinatal complications (pooled aOR = 3.8)( 95% CI: 1.45, 6.15) were among the associated factors for postpartum depression in Ethiopia.ConclusionMore than one in five women was with postpartum depression and factors such as poor marital relations, history of depression, poor social support, domestic violence, unplanned pregnancy, family history of mental illness were related to it. Therefore, maternal postnatal care services should be geared to incorporate this public essential health concern.

2020 ◽  
Vol 13 (1) ◽  
pp. 595-610
Author(s):  
Mogesie Necho ◽  
Merid Abadisharew ◽  
Yemiyamirew Getachew

Background: Maternal mental health in the postpartum period is essential for the optimal development of the newborn. Despite this, a shortage of concrete evidence exists regarding it. Methods: PubMed, Scopus, and EMBASE were investigated with no time limitation. A manual search for a reference list of articles was also done. Relevant data were extracted using the Meta XL package and analysis was done using Stata-11 meta-prop package. Heterogeneity was checked with Cochran's Q-statistics and the Higgs I 2 test. Results: Sixteen studies were included. The average prevalence of postpartum depression was 21.9%. The pooled prevalence was found to be higher in studies assessed with SRQ-20, i.e 24.6% than studies assessed using PHQ-9, which was 18.9%. Moreover, the pooled prevalence was slightly higher in southern Ethiopia (22.6%) than Addis Ababa (21.2%). Poor marital relation (pooled aOR= 3.56) (95% CI: 2.50, 4.63), unplanned pregnancy (pooled aOR=3.48) (95% CI: 2.18, 4.79), previous history of depression (pooled aOR= 4.33) (95% CI: 2.26, 6.59), poor social support (pooled aOR= 4.5) (95% CI: 3.34, 5.56), and domestic violence were among the associated factors for postpartum depression. Conclusion: More than one in five women were found to have postpartum depression and factors such as poor marital relations, history of depression, poor social support, domestic violence, and unplanned pregnancy were observed to be associated with it. Therefore, maternal postnatal care services should integrate this essential health concern.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Zakir Abdu ◽  
Teshome Kabeta ◽  
Lamessa Dube ◽  
Workinesh Tessema ◽  
Mubarek Abera

Background. Mental disorder is one of the greatest challenges that current and future generations will face. Currently among all people suffering from depression, 85% of them live in low- and middle-income countries. Previous studies reported the global burden/prevalence of depression to be five to ten times higher among prisoners than the general population. However, the prevalence of depression among prisoners in our study area is not known. Objective. This study therefore aimed to assess the prevalence and associated factors of depression among prisoners in Jimma town in 2017. Method. A cross-sectional study design was employed on 332 prisoners selected by systematic random sampling method. Data was collected by a face to face interview using Beck Depression Inventory (BDI-II) scale. Data analysis was done using SPSS version 20. Result. The study revealed that 41.9% (n=139) of participants among prisoners had depression. Having family history of mental illness (AOR = 6.05, 95% CI = 2.6, 13.8), having chronic physical illness (AOR = 2.87, 95% CI = 1.29, 6.41), having history of previous incarceration (AOR = 3.26, 95% CI = 1.02, 10.64), lack of job in the prison (AOR = 4.96, 95% CI = 2.09, 11.8), lifetime alcohol use (AOR = 3.61, 95% CI = 1.8, 7.26), thinking life to be a difficult one after release from prison (AOR = 2.07, 95% CI = 1.2, 3.6), having age between 21 and 25 years (AOR = 2.04, 95% CI = 1.06, 3.89), and having poor social support (AOR = 2.2, 95% CI = 1.27, 3.82) had significant association with depression in the fully adjusted final regression model. Conclusion. This study has shown that the prevalence of depression among prisoners was very high. Having family history of mental illness, having chronic physical illness, having previous incarceration, lack of job in prison, lifetime alcohol use, thinking life to be difficult one after release from prison, having age between 21 and 25 years old, and having poor social support were found to have an impact on the prevalence of depression.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247005
Author(s):  
Tadele Amare Zeleke ◽  
Wondale Getinet ◽  
Zemenu Tadesse Tessema ◽  
Kassahun Gebeyehu

Background Globally, post-partum depression is a major public health problem and is associated with a harmful effect on the infant, child, and mothers’ mental, physical, and social health. Although a few post-partum depression studies have been published, we still lack an accurate estimated pooled prevalence of national PPD and associated factors. Objectives This study aims to show the estimated pooled prevalence of PPD and associated factors in Ethiopia. Methods We conduct the extensive search of articles as indicated in the guideline (PRISMA), reporting systematic review and meta-analysis. Databases like MEDLINE, PubMed, psych INFO, Web of Science, EMBASE, CINAHL, Scopus, and The Cochrane Library. All publications and grey literature were addressed by using MeSH terms and keywords. The pooled estimated effect of post-partum depression and associated factors was analyzed using the random effect model meta-analysis, and 95% CI was also considered. Protocol and registration PROSPERO 2020 CRD42020176769 Available from https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020176769. Result A total of 11 studies with 7,582 participants were included in this meta-analysis. The estimated pooled prevalence of post-partum depression (PPD) was 22.08%, with a 95% CI (17.66%, 26.49). For factors associated with post-partum depression, a random effect size model was used during meta-analysis; unplanned pregnancy [(OR = 2.84; 95% CI (2.04, 3.97)], domestic violence [OR = 3.14; 95% CI (2.59, 3.80)], and poor social support [OR = 3.57;95% CI (2.29,5.54) were positively associated factors with post-partum depression. Conclusion and recommendation The estimated pooled prevalence of post-partum depression was high in Ethiopia. Unplanned pregnancy, poor social support, and domestic violence were factors affecting PPD. Therefore, the Ethiopian policymakers and health personnel better give more emphasis to mothers who had a history of unplanned pregnancy, domestic violence, and poor social support


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Merga Siyoum ◽  
Getachew Assfaw ◽  
Henok Yitbark ◽  
Getachew Tesfaw

Background. Depression is a leading cause of major public health problems globally, and its prevalence has been increasing, particularly in low- and middle-income countries including our country. Therefore, this study is aimed at exploring depression symptoms and their determinants among admitted medical and surgical patients which is important to get optimal care for patients. Methods. An institution-based cross-sectional study was conducted from May to June 2019, on adults’ medical and surgical admitted patients at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. The systematic random sampling technique was used to get a total of 590 samples. The standardized hospital anxiety and depression scale (HADS) was used to assess individual depression symptoms. We computed the bivariate and multivariate binary logistic regression analyses to identify factors associated with depression symptoms. Statistical significance was declared at P < 0.05 . Result. The prevalence of depression symptoms was found to be 53.9% (95% CI: 50.2, 57.0). In the multivariable logistic regression, female sex ( AOR = 2.04 , 95% CI: 1.35, 3.09), being single ( AOR = 3.65 , 95% CI: 3.48, 2.10, 5.78), widowed ( AOR = 2.82 , 95% CI: 1.27, 6.30), unable to read and write ( AOR = 2.71 , 95% CI: 1.14, 6.47), admission at medical ward ( AOR = 1.59 , 95% CI: 1.02, 2.46), history of mental illness ( AOR = 1.59 , 95% CI: 1.02, 2.46), and poor social support ( AOR = 2.82 , 95% CI: 1.57, 5.11) were factors significantly associated with depression symptoms. Conclusion. The prevalence of depression symptoms among admitted patients was high. Female sex, being single, widowed, unable to read and write, admission at medical ward, history of mental illness, and poor social support were factors significantly associated with depression symptoms. It is better for the Ministry of Health to give training on how to screen depression among medical and surgical patients, and interventions that would be addressing the awareness of the above factors would be beneficial to prevent further complications.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abate Dargie Wubetu ◽  
Nigus Alemnew Engidaw ◽  
Kefyalew Dagne Gizachew

Abstract Background Postpartum depression explains various groups of depressive symptoms and syndromes that can take place during the first 6 weeks following birth. The postpartum period is a critical time where both mild and severe mood disorders can occur. The familiar forms are baby blues and postpartum depression. Understanding the prevalence and associated factors of postpartum depression is mandatory for early detection and treatment. Methods Institution based cross-sectional study was conducted from 1st May to June 30, 2018. The study participants were eligible women who came to Debre Berhan referral hospital and health centers for postnatal care and vaccination service. The Edinburgh postnatal depression scale was used to assess postpartum depression. A systematic random sampling technique was used to collect the data after determining the skip fraction (k = 2). The collected data were coded and entered into Epi-info version 7 and transported to SPSS version 20 for analysis. Both bivariate and multivariate binary logistic regression were done to identify associated factors. During bivariate analysis, variables with p-value < 0.05 were included in multivariate analysis. Odds ratios and their 95% confidence intervals were computed and variables with p-value less than 0.05 were considered to declare significantly associated factors (multivariate analysis). Results A total of 308 mothers who attended postpartum care we're included, which was a 100% response rate. The prevalence of postpartum depression was found to be 15.6% (95%CI = 11.7, 19.8). Being widowed/widower, having poor social support, having a current hospitalized child, and experienced a death of family member or close relative were significantly associated with postpartum depression. Conclusions The prevalence of postpartum depression was lower than most studies done in different areas. Major life events and traumas are associated with an increased risk of postpartum depression. Health professionals should be aware of the mother’s circumstances during the puerperium, they should initiate support to reduce the risk of depression in the postpartum period. Health care professionals working postpartum care clinics should give special attention to mothers who are widowed/widower, have poor social support, have a current hospitalized children, and experienced a death of family member or close relative.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Solomon Shitu ◽  
Biftu Geda ◽  
Merga Dheresa

Abstract Background Postpartum depression is the most common complication of childbearing age women and is a considerable public health problem. The transition into motherhood is a difficult period that involves significant changes in the psychological, social and physiological aspects, and has increased vulnerability for the development of mental illness. More than 1 in 10 pregnant women and 1 in 20 postnatal women in Ethiopia suffer from undetected depression. Methods Community based cross sectional study was conducted among 596 postpartum mothers in Ankesha District, North West Ethiopia, from February 01 to March 2, 2018. One stage cluster sampling technique was employed to get the study participants. The objective was to assess the prevalence and associated factors of postpartum depression among mothers who gave birth in the last Twelve months in Ankesha District, Awi Zone, North West Ethiopia, 2018. The interviewer-administered questionnaire was used to collect data and Eden Burg Postpartum Depression Scale was used to assess postpartum depression with cutoff point ≥8. The data were entered into Epi data version 3.1 and exported to SPSS version 24 for analysis. All variables with P < 0.25 in the bivariate analysis were included in the final model and statistical significance was declared at P < 0.05. Result In this study, a total of 596 study participants were involved making a response rate of 97.4%, the prevalence of postpartum depression was 23.7% with 95%CI: 20.3–27.2. From the participant mothers who are divorced/widowed/unmarried (AOR = 3.45 95%CI: 1.35–8.82), unwanted pregnancy (AOR = 1.95 95%CI: 1.14–3.33), unpreferred infant sex (AOR = 1.79 95%CI: 1.13–2.86), infant illness (AOR = 2.08 95%CI: 1.30–3.34) and low social support (AOR = 3.16 95% CI: 1.55–6.43) was independent predictors of postpartum depression. Conclusion Almost a quarter (23.7%) of women suffers from postpartum depression. Marital status, unwanted pregnancy, unwanted infant sex, infant illness, and low social support were independent predictors of postpartum depression. Therefore, integration of mental illness with maternal and child health care is important, information communication education and behavioral change communications on postpartum depression are better been given attention.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Yousef Veisani ◽  
Ali Delpisheh ◽  
Kourosh Sayehmiri ◽  
Shahab Rezaeian

Background. Postpartum depression (PPD) is a serious mental health disorder affecting 13% of women in developed communities. The present study reviews available epidemiological publications on PPD-related aspects in Iranian women to help policy makers and health workers to design preventative strategies and further researches.Materials and Methods. A systematic review was constructed based on the computerized literature valid database. The 95% confidence intervals were calculated by random effects models. Metaregression was introduced to explore and explain heterogeneity between studies. Data manipulation and statistical analyses were performed using Stata 11.Results. Overall, 41 studies met the inclusion criteria. The pooled prevalence of PPD in Iran was 25.3% (95% CI: 22.7%–27.9%). Amongst subgroups of unwanted delivery, illiterate, housewives, and having history of depression the prevalence was 43.4% (35.6–51.1), 31.6% (18.1–45.0), 30.7% (25.2–36.3), and 45.2% (35.4–53.1), respectively.Conclusions. Interventions that would specifically target women with a prior history of depression, illiterates, housewives, or women with unwanted pregnancies could be helpful to decrease the prevalence of postpartum depression in Iran.


2020 ◽  
Author(s):  
Getasew Legas ◽  
Getnet Mehretie ◽  
Sintayehu Asnakew ◽  
Amsalu Belete ◽  
Shegaye Shumet

Abstract Background: Common mental disorders such as depression, anxiety and somatic symptoms are a public health concern. It has physical health, psychological and economic consequences. These illness is an emerging issue in Ethiopia.Therefore, this study aimed to assess the prevalence of common mental disorders and associated factors among residents of south Gondar zone 2018.Methods: In this cross-sectional study,731 respondents were recruited for interrviews using a systematic random sampling technique.The self reporting questionnaire was used to assess common mental disorders. List of Threatening Experiences, and the Oslo social support instruments were used to assess the factors. We computed bivariate and multivariable binary logistic regressions to assess factors associated with common mental disorders. Statistical significance was declared at P-value <0.05.Result: A total of 731 participants were interviewed, with a response rate of 98.5%. The prevalence of common mental disorders was 29.7% with (95% CI: 26.4-33.1).In the multivariate logistic regression,female sex (adjusted odds ratio (AOR)= 2.47, 95% CI : 1.68, 3.62),poor social support( AOR =2.34, 95% CI:1.50, 3.64), family history of mental illness(AOR =2.15, 95% CI:1.32-3.51), current use of khat(AOR =1.69, 95% CI: 1 .07, 2.64) and tobacco(AOR=1.71, 95% CI:1.04-2.84), and rural residence(AOR=2.01, 95% CI: 1.35, 3.01) were factors significantly associated with CMDs.Conclusion and recommendations: The prevalence of common mental disorders was found to be high. Female sex, current substance use (khat chewing (leaves) and tobacco smoking), unemployment, rural residence, family history mental illness, and poor social support were significantly associated with common mental disorder. Therefore; It is necessary to give emphasis to individuals with family history of mental illness, women, and history of mental illness.


2021 ◽  
Author(s):  
Hasan RAWASHDEH ◽  
Zahra ALALWANI ◽  
Amer SINDIANI ◽  
Rana ALODETALAH ◽  
Mohammad ALQUDAH

Abstract Background: About one in five women suffer from postpartum depression, placing it the leading complication during childbirth. Oxytocin has been suggested to play a key role in modulating maternal behaviour and stress-related disorders. However, there is little evidence to support its role in predicting postpartum depression. Our aim is to investigate the relationship between serum oxytocin level in the third trimester and early-onset postpartum depression symptoms and whether oxytocin is capable of predicting postpartum depression symptoms.Methods: A total of 172 healthy pregnant women participated in this cross-sectional descriptive study. The serum oxytocin level was measured between 34 and 37 weeks. A validated Edinburgh Postnatal Depression Scale (EPDS) was used to assess symptoms of depression four to six weeks postpartum. Participants with EPDS scores of 13 or more were considered having depressive symptoms. SPSS version 23 was used for data analysis. Descriptive statistics were provided. Independent sample t-test and Pearson r were used to examine differences in depression scores between selected demographic, psychosocial, and clinical variables. The level of significance for all analyses was set at α=0.05.Results: 8% of participants have scored 13 or above at the EPDS. Pearson r indicated that there was no correlation between EPDS scores and oxytocin level r(170)=0.10, p=0.23. Furthermore, there was no correlation between EPDS scores and oxytocin level among women with a lifetime history of depression, r(43)= - 0.13, p=0.37. Independent t-test has shown that participants with low education, low income, previous history of depression, positive family history of depression, positive family issues and absent emotional family support have scored significantly higher on EPDS scores than their counterparts. The association with a previous lifetime history of depression was noticeable t(170)= - 4.40, p<0.001.Conclusions: There was no relation between late antenatal third trimester serum oxytocin level and early onset postpartum depression symptoms. Third trimester serum oxytocin level alone was not capable of predicting early onset postpartum depression.


2020 ◽  
Author(s):  
abate dargie ◽  
Nigus Alemnew Engidaw ◽  
Kefyalew Dagne Gizachew

Abstract Background: Postpartum depression explains various groups of depressive symptoms and syndromes that can take place during the first 6 weeks following birth. The postpartum period is a critical time where both mild and severe mood disorders can occur. The familiar forms are baby blues and postpartum depression. Understanding the prevalence and associated factors of postpartum depression is mandatory for early detection and treatment. Methods: Institution based cross-sectional study was conducted from 1st May to June 30, 2018. The study participants were eligible women who came to Debre Berhan referral hospital and health centers for postnatal care and vaccination service. The Edinburgh postnatal depression scale was used to assess postpartum depression. A systematic random sampling technique was used to collect the data after determining the skip fraction (k=2). The collected data were coded and entered into Epi-info version 7 and transported to SPSS version 20 for analysis. Both bivariate and multivariate binary logistic regression were done to identify associated factors. During bivariate analysis, variables with p-value < 0.05 were included in multivariate analysis. Odds ratios and their 95% confidence intervals were computed and variables with p-value less than 0.05 were considered to declare significantly associated factors (multivariate analysis). Results: A total of 308 mothers who attended postpartum care included, which was a 100% response rate. The prevalence of postpartum depression was found to be 15.6% ( 95%CI=11.7, 19.8). Being widowed/widower, have poor social support, have currently hospitalized child, and had experienced a death of family member or close relative were significantly associated with postpartum depression. Conclusions: the prevalence of postpartum depression was lower than most studies done in different areas. Major life events and traumas are associated with an increased risk of postpartum depression. Health professionals should be aware of the mother’s circumstances during the puerperium, they should initiate support to reduce the risk of depression in the postpartum period. Health care professionals working postpartum care clinics should give special attention to mothers who were widowed/widower, have poor social support, have currently hospitalized children, and had experienced a death of a family member or close relative.


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