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Factors associated with postpartum complications: A systematic review to inform early detection strategies
Elisa Ulfiana1,2, Tandiyo Rahayu1, Yuni Wijayanti1
1Public Health Doctoral Programs, Faculty of Medicine, Universitas Negeri Semarang, Semarang, Central Java, Indonesia.
Insights
Postpartum complications are linked to various psychosocial, demographic, and clinical factors. Early detection and comprehensive care are crucial for improving maternal health outcomes and reducing risks.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Public Health
Background:
- Postpartum complications pose significant risks to maternal and newborn health globally.
- These complications are major contributors to maternal morbidity and mortality worldwide.
- Understanding associated factors is key to improving postpartum care.
Purpose of the Study:
- To systematically review and synthesize evidence on factors associated with postpartum disease complications.
- To identify key risk factors contributing to adverse postpartum outcomes.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched Scopus and PubMed for studies published between 2014-2024.
- Included quantitative and qualitative studies addressing postpartum complications.
Main Results:
- Thirteen studies identified significant factors including postpartum hemorrhage, advanced maternal age (>35), mental health disorders (depression, anxiety), preeclampsia, and multiple pregnancies.
- Delivery type, infant health, childhood trauma, low social support, lower educational attainment, social isolation, and marital dissatisfaction were also associated.
- While not directly evaluated, identified risk factors suggest benefits of targeted screening and support.
Conclusions:
- Multiple psychosocial, demographic, and clinical factors are linked to postpartum complications.
- Highlights the critical need for early detection and comprehensive postpartum care.
- Findings emphasize strategies to mitigate risks and enhance maternal health outcomes.
Background:
Complications during the puerperium present abnormal conditions that can jeopardize the health and well-being of both mother and newborn. These complications are significant contributors to maternal morbidity and mortality worldwide. This systematic review aims to identify and synthesize evidence on the factors associated with postpartum disease complications.
Methods:
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was registered in PROSPERO (CRD420251013692). A comprehensive search was performed using electronic databases, including Scopus and PubMed, to identify relevant studies published between 2014 and 2024. Eligible studies included full-text, peer-reviewed articles that used quantitative or qualitative designs and addressed postpartum complications in accordance with the PEO framework. Descriptive analysis was used to synthesize findings.
Results:
A total of 907 records were identified, and 13 studies met the inclusion criteria. The findings highlight a range of factors significantly associated with postpartum complications, including postpartum hemorrhage, maternal age >35 years, depressive and anxiety disorders, preeclampsia, multiple pregnancies, type of vaginal delivery, infant-related health concerns, childhood trauma, low social support, low educational attainment of both mothers and husbands, perceived social isolation, and marital dissatisfaction. While early detection and intervention were not directly evaluated in these studies, the identification of these risk factors suggests that targeted screening and supportive strategies may be beneficial in mitigating postpartum complications.
Conclusions:
This review identifies multiple psychosocial, demographic, and clinical factors associated with postpartum complications. These findings underscore the importance of early detection and comprehensive postpartum care to mitigate risks and improve maternal health outcomes.
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