Department of Physiotherapy, Evangel University Akaeze, Ebonyi State, Nigeria.
Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Womens Health (Lond). 2022 Jan-Dec;18:17455057221118773. doi: 10.1177/17455057221118773.
Postpartum depression (PPD) is a common mental health challenge in resource-constrained sub-Saharan Africa (SSA). Characterizing its correlates will aid prediction, early detection, and pre-emptive interventions. This review aimed to systematically synthesize and stratify PPD correlates in sub-Saharan Africa. The review was structured as per the Preferred Reporting Item for Systematic Reviews and Meta-Analyses. We included studies that reported the correlates of PPD in SSA. We searched PubMed, Medline, CINAHL, Academic Search Complete, and PsycINFO for relevant peer-reviewed literature. The correlates of PPD constituted the primary outcome. A random effect model was fitted to estimate the pooled correlation coefficient per correlate. The clinical relevance of correlates was stratified based on strength of correlation (r) and recurrence (f). The mean age of the participants was 27.0 ± 6.0 years, and 68.6% of participants had completed at least secondary education. The correlates of PPD in SSA were intimate partner violence (IPV) ((risk weight (rw) = 2.8; r = 0.212 (confidence interval (CI): 0.11-0.31), poor social support (PSS) (rw = 1.9; r = 0.250 (0.133-0.361)), unwanted pregnancy (UP) (rw = 1.6; r = 0.279 (CI: 0.14-0.41); I = 95.89), and maternal age (MA) (rw = 0.96; r = 0.27 (CI: 0.154-0.37)), among others. A cumulative risk weight of ⩾0.95 was predictive of PPD and marks the critical point at which preemptive interventions should be instituted. The stratification of risk PPD factors and computation of risk stability index are useful in identifying the clinical significant risk factors. The provision of critical risk point will simplify early detection thus facilitating cost-effectiveness. Of the correlates of PPD in SSA, IPV, PSS, UP, and MA are the most important. Targeted screening and pre-emptive interventions for women with high risk weight may be a reasonable strategy both in the short and long term.
产后抑郁症（PPD）是资源有限的撒哈拉以南非洲（SSA）地区常见的心理健康挑战。描述其相关因素将有助于预测、早期发现和预防性干预。本综述旨在系统地综合和分层撒哈拉以南非洲地区 PPD 的相关因素。综述按照系统评价和荟萃分析的首选报告项目进行构建。我们纳入了报告 SSA 中 PPD 相关因素的研究。我们在 PubMed、Medline、CINAHL、Academic Search Complete 和 PsycINFO 中搜索了相关的同行评审文献。PPD 的相关因素是主要的结局。使用随机效应模型估计每个相关因素的汇总相关系数。根据相关性（r）和复发率（f），对相关因素的临床意义进行分层。参与者的平均年龄为 27.0±6.0 岁，68.6%的参与者完成了至少中学教育。SSA 中 PPD 的相关因素包括亲密伴侣暴力（IPV）（风险权重（rw）=2.8；r=0.212（置信区间（CI）：0.11-0.31））、不良社会支持（PSS）（rw=1.9；r=0.250（0.133-0.361））、意外怀孕（UP）（rw=1.6；r=0.279（CI：0.14-0.41）；I=95.89）和产妇年龄（MA）（rw=0.96；r=0.27（CI：0.154-0.37））等。风险权重 ⩾0.95 的累积值预测 PPD，这是应该开始预防性干预的临界点。PPD 风险因素的分层和风险稳定性指数的计算有助于确定具有临床意义的风险因素。提供关键风险点将简化早期检测，从而提高成本效益。在 SSA 中，PPD 的相关因素中，IPV、PSS、UP 和 MA 是最重要的。针对高风险权重的女性进行有针对性的筛查和预防性干预可能是一种短期和长期都合理的策略。
