Padhani Zahra Ali, Salam Rehana A, Rahim Komal Abdul, Naz Samra, Zulfiqar Asma, Ali Memon Zahid, Meherali Salima, Atif Maria, Lassi Zohra S
School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
Health Psychol Behav Med. 2024 Aug 9;12(1):2383468. doi: 10.1080/21642850.2024.2383468. eCollection 2024.
Perinatal mental health issues affect approximately 10% of women in high-income countries and 30% in low- or middle-income countries. This review aims to determine the prevalence of perinatal depression among mothers and fathers in Pakistan and identify associated risk factors.
We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included quantitative studies on the prevalence or incidence of maternal and paternal perinatal depression, including antenatal or postnatal depression in Pakistan, with or without associated risk factors. We performed an electronic search, dual-title/abstract and full-text screening, and data extraction. Analysis was conducted on Revman and JBI SUMARI software. The quality of the included studies was assessed with the NHLBI tool. This review updated a previously published review that included 43 studies, with the last search date of 31st May 2019, now extended to literature published up to June 30, 2023.
Consistent with the previous review, our analysis of 61 studies indicated a pooled prevalence of 37% (95% confidence interval (CI): 30.6-43.6) for maternal antenatal depression. Postnatal depression at different time points, revealed rates of 34.2% (95% CI: 22.7-46.7), 40.9% (95% CI: 0-97.4), and 43.1% (95% CI: 24.4-62.9) at 3, 6 and 12 months, respectively. Paternal postnatal depression was observed at 40.5% (95% CI: 14.9-69) based on two studies. Risk factors for maternal perinatal depression include multiparity, contraceptive failure, inadequate antenatal care, pregnancy-induced hypertension, previous psychiatric illness, passive smoking, drug abuse, low socio-economic status, marital problems, family hardships, recent bereavement, housing difficulties, food insecurity, husband's illiteracy, his unemployment, and being blamed for child disability.
The findings reveal a high prevalence of perinatal depression among mothers with very limited evidence of fathers residing in Pakistan, emphasising the need for prospective studies addressing mental health challenges.
This review is registered on PROSPERO (CRD42023442581).
围产期心理健康问题在高收入国家影响约10%的女性，在低收入或中等收入国家影响30%的女性。本综述旨在确定巴基斯坦母亲和父亲中围产期抑郁症的患病率，并确定相关风险因素。
我们按照系统评价和Meta分析的首选报告项目指南进行了系统评价和Meta分析。我们纳入了关于巴基斯坦孕产妇和父/夫围产期抑郁症患病率或发病率的定量研究，包括产前或产后抑郁症，无论是否有相关风险因素。我们进行了电子检索、双标题/摘要和全文筛选以及数据提取。使用Revman和JBI SUMARI软件进行分析。使用美国国立心、肺、血液研究所（NHLBI）工具评估纳入研究的质量。本综述更新了之前发表的一篇综述，该综述纳入了43项研究，最后一次检索日期为2019年5月31日，现在扩展到截至2023年6月30日发表的文献。
与之前的综述一致，我们对61项研究的分析表明，孕产妇产前抑郁症的合并患病率为37%（95%置信区间（CI）：30.6 - 43.6）。在不同时间点的产后抑郁症显示，在3个月、6个月和12个月时的患病率分别为34.2%（95%CI：22.7 - 46.7）、40.9%（95%CI：0 - 97.4）和43.1%（95%CI：24.4 - 62.9）。根据两项研究，父/夫产后抑郁症的患病率为40.5%（95%CI：14.9 - 69）。孕产妇围产期抑郁症的风险因素包括多胎妊娠、避孕失败、产前护理不足、妊娠期高血压、既往精神疾病、被动吸烟、药物滥用、社会经济地位低、婚姻问题、家庭困难、近期丧亲、住房困难、粮食不安全、丈夫文盲、丈夫失业以及因孩子残疾而受到指责。
研究结果显示，巴基斯坦母亲中围产期抑郁症的患病率很高，而关于父亲的证据非常有限，这凸显了开展前瞻性研究以应对心理健康挑战的必要性。
本综述已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42023442581）。
