The Relationship Between Postpartum Depression and Timely Child Vaccination: A Systematic Review

Background/Objective: Vaccines administered during early childhood rely on caregivers being aware, willing, and able to vaccinate their child. Postpartum depression (PPD) could adversely affect a parent's ability to undertake such preventive care. This systematic review sought to examine the relationship between PPD and timely vaccination in children. Methods: We systematically searched eight databases (MEDLINE ALL, Embase, PsycINFO, CINAHL, LILACS, Web of Science, Sociological Abstracts, and Scopus) from database inception to September 2023. We also reviewed reference lists of included studies. We included primary studies that examined the association between PPD and child vaccination status between birth and 24 months. Two researchers independently extracted data and assessed study quality. Results: In total, 5504 records were screened for eligibility. Of the 50 articles included in full-text assessment, 12 met the eligibility criteria. Most studies (83%) were conducted in high-income countries, with a minority (17%) from lower-middle income countries (LMICs). The sample size of studies varied from <500 (33%) to >450,000 participants (17%). Overall, six studies (50%) found a relationship between maternal PPD and child vaccinations not completed on time, and six (50%) found no relationship. In most studies that were assessed to be of high-quality and found a relationship, the magnitude of the absolute risk was small. Conclusions: We detected significant heterogeneity among the included studies. Further high-quality research using standardized definitions is needed to determine whether parents with PPD may require tailored strategies and supports that consider their symptoms and specific barriers to vaccination.