The prevalence of postpartum depression among women with physical disabilities: a systematic review and meta-analysis

Pregnant and postpartum mothers with physical disabilities face discrimination in healthcare settings and high rates of maternal and obstetric complications, as well as having higher rates of lifetime depression prior to pregnancy, potentially increasing their likelihood of experiencing postpartum depression (PPD). Some studies have found higher rates of PPD in mothers with physical disabilities than in mothers without physical disabilities, with more disabling symptoms associated with worse PPD systems; however, the literature is sparse and heterogenous. This systematic review and meta-analysis advanced this area of study by evaluating the strength of the association between PPD and physical disability.

We searched PubMed and PsycInfo, with the primary inclusion criteria being that the studies had an established measure of depression in women during the postpartum period and either a cohort identified as having physical disability or an established measure of physical disability in a general population sample. We aggregated the prevalence of PPD in women with physical disabilities and tested the robustness of our findings to moderators, including region, sample population, and measure type.

Findings from our quantitative meta-analysis (n=14) demonstrated a strong (d=.76, p<.0001) association between PPD and physical disabilities, such that individuals with physical disabilities reported more depression symptoms than individuals without physical disabilities. Moderator analyses were null, revealing that the association between PPD and physical disabilities was robust to several variables. Qualitative results support our conclusion that individuals with physical disabilities are at increased risk of PPD symptoms.

Our findings of a strong association between physical disability and PPD support the need for more research. Additional studies would 1) augment a nuanced understanding of how best to conceptualize PPD in women with physical disabilities and 2) facilitate testing the robustness of the association between PPD and physical disabilities to additional important moderators.