India's Silent Struggle: A Scoping Review on Postpartum Depression in the Land of a Billion Mothers

Overview

Journal Indian J Psychol Med

Publisher Sage Publications

Specialty Psychiatry

Date 2024 Nov 20

PMID 39564219

Authors

Rajeev S P

Gokul M Nair

Krishna K K

Chris Maria

Affiliations

Soon will be listed here.

Abstract

Background: Postpartum emotional issues, including postpartum blues, postpartum psychosis, and postpartum depression (PPD), affect many mothers worldwide. The prevalence of postpartum blues ranges from 300 to 750 per 1,000 mothers, while postpartum psychosis has a prevalence of 0.89-2.6 cases per 1,000 births. PPD affects 100-150 new mothers per 1,000 births, and its prevalence can go above 25% globally. Depression in mothers can have long-lasting impacts on children and the next generation, affecting their growth, development, and relationships. However, the condition of PPD is frequently misdiagnosed, and women who suffer from it do not receive treatment. There is a lack of solid systematic evidence that looks at the overall burden of PPD and the risk factors that are associated with it in India. The awareness of PPD is critical in managing the symptoms and seeking professional support, and studies are needed to evaluate and assess the situation in India.

Methodology: This study is a systematic literature review with a scoping review approach aimed at providing existing evidence on the awareness and prevalence of PPD in India. The search strategy for the electronic bibliographic search included a list of related terms and factors of awareness and prevalence of PPD. The search encompassed six prominent databases. The assessment tools used in studies from 2012 to 2023 study the factors using the Postpartum Depression Literacy Scale (PoDLiS) and the Edinburgh Postpartum Depression Scale, which measure the awareness and prevalence of PPD.

Results: The study found a significantly low volume of studies conducted in India to determine the prevalence of PPD. The materials or studies accessible are hospital-based research with a minimal number of samples. The reported prevalence rate of postpartum depression (PPD) in India varies across different studies, ranging from 4% to 48.5%. Among mothers who gave birth either naturally or by cesarean section in a hospital setting, one study reported the lowest prevalence rate (4%). The prevalence of PPD among women in India is estimated to be 18% based on the average score across all research. A study that evaluated the moms in the community found that PPD was prevalent in new mothers at a rate of 21.5%. There are three studies, in particular, that focus on how aware people are of PPD. Two studies found that 54% of the family members of postpartum moms and women undergoing tertiary pediatric care are aware of PPD.

Discussion: Many studies point to the lack of social support as a significant risk factor for mental health complications after delivery. History of depression, anxiety, adverse life events, partner abuse, low economic status, complications at childbirth, and a traumatic childbirth experience are some of the associated factors identified in the studies. Studies have also shown that women who undergo a cesarean section have a higher risk of developing PPD than those with a vaginal delivery.

References

Poreddi V, Thomas B, Paulose B, Jose B, Daniel B, Somagattu S . Knowledge and attitudes of family members towards postpartum depression. Arch Psychiatr Nurs. 2020; 34(6):492-496. DOI: 10.1016/j.apnu.2020.09.003. View

Lanjewar S, Nimkar S, Jungari S . Depressed Motherhood: Prevalence and Covariates of Maternal Postpartum Depression among Urban Mothers in India. Asian J Psychiatr. 2021; 57:102567. DOI: 10.1016/j.ajp.2021.102567. View

Ana Y, Lewis M, van Schayck O, Babu G . Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms?: Results from MAASTHI cohort study in South India. J Psychosom Res. 2021; 144:110390. PMC: 7611353. DOI: 10.1016/j.jpsychores.2021.110390. View

Dubey C, Gupta N, Bhasin S, Muthal R, Arora R . Prevalence and associated risk factors for postpartum depression in women attending a tertiary hospital, Delhi, India. Int J Soc Psychiatry. 2011; 58(6):577-80. DOI: 10.1177/0020764011415210. View

Sidhu G, Sidhu T, Kaur P, Lal D, Sangha N . Evaluation of Peripartum Depression in Females. Int J Appl Basic Med Res. 2019; 9(4):201-205. PMC: 6822329. DOI: 10.4103/ijabmr.IJABMR_23_19. View

Johnson A, Edwin S, Joachim N, Mathew G, Ajay S, Joseph B . Postnatal depression among women availing maternal health services in a rural hospital in South India. Pak J Med Sci. 2015; 31(2):408-13. PMC: 4476352. DOI: 10.12669/pjms.312.6702. View

VidhiChaudhary , Puri M, Kukreti P, Chhapola V, Kanwar D, Tumpati A . Postpartum depression in Covid-19 risk-stratified hospital zones: A cross-sectional study from India. J Affect Disord Rep. 2021; 6:100269. PMC: 8550899. DOI: 10.1016/j.jadr.2021.100269. View

Singh G, Ranjan A, Agarwal N, Kumar P . Assessment of magnitude and predictors of postpartum depression among mothers attending immunization clinics in Bihar, India. J Family Med Prim Care. 2021; 10(1):312-320. PMC: 8132757. DOI: 10.4103/jfmpc.jfmpc_1676_20. View

Zaidi F, Nigam A, Anjum R, Agarwalla R . Postpartum Depression in Women: A Risk Factor Analysis. J Clin Diagn Res. 2017; 11(8):QC13-QC16. PMC: 5620853. DOI: 10.7860/JCDR/2017/25480.10479. View

10.

Khalil H, Peters M, McInerney P, Godfrey C, Alexander L, Evans C . The role of scoping reviews in reducing research waste. J Clin Epidemiol. 2022; 152:30-35. DOI: 10.1016/j.jclinepi.2022.09.012. View

11.

Ozcan N, Boyacioglu N, Dinc H . Postpartum Depression Prevalence and Risk Factors in Turkey: A Systematic Review and Meta-Analysis. Arch Psychiatr Nurs. 2017; 31(4):420-428. DOI: 10.1016/j.apnu.2017.04.006. View

12.

Doke P, Vaidya V, Narula A, Datar M, Vasantrao Patil A, Panchanadikar T . Assessment of difference in postpartum depression among caesarean and vaginally delivered women at 6-week follow-up in hospitals in Pune District, India: an observational cohort study. BMJ Open. 2021; 11(9):e052008. PMC: 8487184. DOI: 10.1136/bmjopen-2021-052008. View

13.

Priya T, Kaushal S, Dogra P, Dogra V . Prevalence and risk factors of postpartum depression in sub-Himalayan region. Med J Armed Forces India. 2024; 80(2):161-165. PMC: 10954492. DOI: 10.1016/j.mjafi.2021.12.003. View

14.

Patel H, Ganjiwale J, Nimbalkar A, Vani S, Vasa R, Nimbalkar S . Characteristics of Postpartum Depression in Anand District, Gujarat, India. J Trop Pediatr. 2015; 61(5):364-9. DOI: 10.1093/tropej/fmv046. View

15.

Tareen R, Tandon R . A stitch in time saves nine: Untreated perinatal depression hurts future generations. Asian J Psychiatr. 2018; 38:A1-A3. DOI: 10.1016/j.ajp.2018.11.009. View

16.

Upadhyay R, Chowdhury R, Aslyeh Salehi , Sarkar K, Singh S, Sinha B . Postpartum depression in India: a systematic review and meta-analysis. Bull World Health Organ. 2017; 95(10):706-717C. PMC: 5689195. DOI: 10.2471/BLT.17.192237. View

17.

Sheela C, Venkatesh S . Screening for Postnatal Depression in a Tertiary Care Hospital. J Obstet Gynaecol India. 2016; 66(Suppl 1):72-6. PMC: 5016406. DOI: 10.1007/s13224-015-0766-x. View

18.

Gupta S, Kishore J, Mala Y, Ramji S, Aggarwal R . Postpartum depression in north Indian women: prevalence and risk factors. J Obstet Gynaecol India. 2014; 63(4):223-9. PMC: 3763048. DOI: 10.1007/s13224-013-0399-x. View

19.

Poreddi V, Sundaram V, Reddy S, Bidadi K, Thimmaiah R . Postpartum depression: Mental health literacy of Indian mothers. Arch Psychiatr Nurs. 2021; 35(6):631-637. DOI: 10.1016/j.apnu.2021.09.003. View

20.

Mishra K, Mohapatra I, Rout R . An epidemiological study on depression among women during postpartum period in an urban slum of Bhubaneswar. J Family Med Prim Care. 2020; 9(9):4736-4740. PMC: 7652148. DOI: 10.4103/jfmpc.jfmpc_793_20. View