Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Division of Epidemiology and Prevention: Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland.
J Affect Disord. 2021 Jan 15;279:737-748. doi: 10.1016/j.jad.2020.11.053. Epub 2020 Nov 12.
Despite remarkable progress in the reduction of maternal mortality, postpartum depression remains a major public health problem among vulnerable populations. In Ethiopia, study findings regarding postpartum depression and its association with intimate partner violence and social support have been inconsistent. Therefore, this systematic review and meta-analysis estimate the pooled prevalence of postpartum depression and its association with intimate partner violence and inadequate social support in Ethiopia.
We systematically searched international databases like PubMed, Web of Science, SCOPUS, CINAHL, PsycINFO, Google Scholar, Science Direct, and the Cochrane Library. All identified observational studies reporting the postpartum depression and or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. The I statistics were used to assess the heterogeneity of the studies. A random-effects model was computed to estimate the pooled prevalence of postpartum depression and its associations with the selected predictors.
The random effect meta-analysis of thirteen studies showed a pooled prevalence of postpartum depression was 21.55% (95% CI: 17.89, 25.94). The highest prevalence of postpartum depression occurred in Addis Ababa, 23.3% and the lowest was in Harar, 13.11%. Our meta-analysis indicated a 5.46 folds increased risk of postpartum depression among women exposed to intimate partner violence (POR = 5.46 (95%CI: 3.94, 7.56, I=38.8%) and 6.27 folds increased risk postpartum depression among women who had inadequate social support (POR = 6.27 (95%CI: 4.83, 8.13, I2=0) relative to those who had adequate social support. The meta-analysis further revealed that marital dissatisfaction (POR = 2.6%; 95%CI: 1.48-4.65), previous postpartum depression (POR = 2.03%; 95%CI: 1.72-2.4), and substance abuse (POR = 2.03%; 95%CI: 1.72-2.4) were associated with postpartum depression.
Our study indicates that two in every ten postpartum women in Ethiopia are suffering from postpartum depression. Intimate partner violence and social support should be a major focus to improve women's mental health during postpartum period with the reduction of substance abuse. There is an urgent need for concerted efforts in the reduction of postpartum depression through prevention efforts of intimate partner violence and substance abuse.
尽管在降低产妇死亡率方面取得了显著进展，但产后抑郁症仍是脆弱人群中的一个主要公共卫生问题。在埃塞俄比亚，关于产后抑郁症及其与亲密伴侣暴力和社会支持的关联的研究结果一直不一致。因此，本系统评价和荟萃分析旨在估计埃塞俄比亚产后抑郁症的总患病率及其与亲密伴侣暴力和社会支持不足的关联。
我们系统地检索了国际数据库，如 PubMed、Web of Science、SCOPUS、CINAHL、PsycINFO、Google Scholar、Science Direct 和 Cochrane Library。纳入了所有报告埃塞俄比亚产后抑郁症及其预测因素的观察性研究。两位作者使用标准化数据提取格式独立提取所有必要数据。使用 I ² 统计量评估研究的异质性。采用随机效应模型计算产后抑郁症及其与所选预测因素关联的总患病率。
对 13 项研究的随机效应荟萃分析显示，产后抑郁症的总患病率为 21.55%（95%CI：17.89，25.94）。产后抑郁症患病率最高的是亚的斯亚贝巴，为 23.3%，最低的是哈拉尔，为 13.11%。我们的荟萃分析表明，与有足够社会支持的妇女相比，遭受亲密伴侣暴力的妇女产后抑郁症的风险增加 5.46 倍（POR=5.46（95%CI：3.94，7.56，I=38.8%），社会支持不足的妇女产后抑郁症的风险增加 6.27 倍（POR=6.27（95%CI：4.83，8.13，I ² =0）。荟萃分析进一步表明，婚姻不满（POR=2.6%；95%CI：1.48-4.65）、既往产后抑郁症（POR=2.03%；95%CI：1.72-2.4）和物质滥用（POR=2.03%；95%CI：1.72-2.4）与产后抑郁症相关。
我们的研究表明，埃塞俄比亚每十名产后妇女中就有两名患有产后抑郁症。亲密伴侣暴力和社会支持应该是改善妇女产后期间心理健康的重点，同时减少物质滥用。迫切需要通过预防亲密伴侣暴力和物质滥用来共同努力降低产后抑郁症。
