Epidemiology, pathophysiology, and interventions for postpartum depression: Systematic review.

Area of Science:

• Reproductive Psychiatry
• Maternal-Child Health
• Global Mental Health

Background:

• Postpartum depression (PPD) is a significant psychiatric disorder impacting mothers, infants, and families.
• Disparities persist in PPD screening, diagnosis, and treatment, especially in diverse, low-resource settings.
• Complex biological and psychosocial factors necessitate integrated approaches for effective PPD management.

Purpose of the Study:

• To synthesize evidence on PPD risk factors, mechanisms, and interventions.
• To identify directions for achieving equitable postpartum depression care globally.

Main Methods:

• A narrative review adhering to PRISMA 2020 guidelines.
• Systematic search of PubMed, Web of Science, EMBASE, and PsycINFO (Jan 2010-May 2025).
• Inclusion of 84 studies (cohort, RCTs, meta-analyses) on PPD epidemiology, risk, mechanisms, and interventions.

Main Results:

• PPD results from hormonal, neurochemical, psychosocial, and cultural interactions.
• Key risk factors include history of depression, antenatal anxiety, low self-efficacy, and poor social support.
• Effective interventions include screening tools (e.g., Edinburgh Postnatal Depression Scale), therapies (CBT, IPT), and medications (brexanolone, zuranolone).
• Culturally adapted, community-integrated models and emerging biomarkers show promise for enhanced PPD detection and outcomes.

Conclusions:

• Integrative, culturally sensitive strategies are essential for effective PPD management.
• Prioritizing scalable, personalized, non-pharmacological interventions can reduce disparities.
• Enhancing maternal mental health equity across diverse populations requires tailored PPD care approaches.