Perinatal depression in Pakistan: A systematic review and meta-analysis

Area of Science:

• Public Health
• Epidemiology
• Maternal Mental Health

Background:

• Perinatal depression poses a significant global health challenge.
• Understanding its prevalence and risk factors in diverse settings like Pakistan is crucial for targeted interventions.

Purpose of the Study:

• To estimate the prevalence of antenatal and postnatal depression in Pakistan.
• To identify associated risk factors for perinatal depression in the Pakistani population.

Main Methods:

• A systematic literature search was conducted across major databases (Medline, PsycINFO, CINAHL, EMBASE, Global Health) up to May 2019.
• Included studies reported on the prevalence and/or risk factors of perinatal depression among women in Pakistan.
• Data from 43 studies involving 17,544 women were synthesized.

Main Results:

• The pooled prevalence of antenatal depression was 37% (95% CI: 30-44) and postnatal depression was 30% (95% CI: 25-36).
• Prevalence did not significantly differ between urban and rural areas.
• Intimate partner violence and poor spousal relationships were linked to antenatal depression, while low income was associated with postnatal depression. Unintended pregnancy was a significant risk factor for perinatal depression.

Conclusions:

• Significant variability exists in reported perinatal depression rates in Pakistan, potentially due to diverse risk factors and data collection methods.
• The high prevalence rates (30-37%) exceed global estimates, highlighting an urgent need for increased resources and policy attention to maternal mental health services in Pakistan.