Maternal psychological distress on delayed onset of lactation II: A meta-analysis

Existing studies suggest a potential association between maternal psychological distress and delayed onset of lactation II (DOLII), but the evidence remains inconclusive.

A systematic literature search was conducted in PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, China National Knowledge Infrastructure, WANFANG, and VIP databases, from database inception to August 30, 2024. Two independent reviewers screened articles, extracted data, and assessed study quality. Discrepancies were resolved through discussion. Meta-analysis was performed using Revman 5.3 software after data extraction. This review was registered with the International Prospective Register of Systematic Reviews (CRD42024536705).

Pooled effect sizes demonstrated positive associations between the DOLII and postpartum anxiety (odds ratio [OR] = 2.83, 95% confidence interval [CI]: 1.86-4.33), postpartum depression (OR = 2.30, 95% CI: 1.66-3.18), and postpartum fatigue (OR = 1.93, 95% CI: 1.12-3.33). In contrast, the associations between DOLII and prenatal anxiety (OR = 1.34, 95% CI: 0.94-1.92), prenatal depression (OR = 1.44, 95% CI: 0.84-2.48), and fear of labor (OR = 1.30, 95% CI: 0.77-2.19) were not statistically significant.

This study synthesized data from multiple studies to investigate the association between maternal psychological distress and DOLII. However, beyond postpartum depression, there is a paucity of research on this topic. Further high-quality, large sample studies are needed to comprehensively investigate the relationship between maternal psychological distress and DOLII.