Mari Addo Kwaku, Khan Hafiz T A, Ohl Madeleine
Department of Obstetrics and Gynaecology, University of Ghana Medical Centre Ltd., Accra, Ghana.
Public Health Group, University of West London, London, UK.
J Biosoc Sci. 2025 May 13:1-20. doi: 10.1017/S0021932025000264.
Hypertensive disorders of pregnancy (HDP) and postpartum depression (PPD) are significant global health challenges affecting maternal and child well-being. HDP, including pre-eclampsia, gestational hypertension, and chronic hypertension, complicate up to 10% of pregnancies worldwide, with profound implications for maternal mortality, particularly in low- to middle-income countries (LMICs) like Ghana. The incidence of HDP is rising globally, contributing substantially to maternal deaths and severe perinatal outcomes such as stillbirth and low birth weight. Concurrently, perinatal mental health issues, including PPD, affect a significant proportion of women globally, with higher prevalence rates observed in LMICs. Despite the known physiological impacts of HDP, their association with maternal mental health remains underexplored, especially in LMIC contexts. A systematic review and meta-analysis were conducted to explore the association between HDP and PPD in LMICs, focusing on available literature and studies from diverse global settings. Additionally, semi-structured qualitative interviews were conducted with healthcare professionals in Ghana to gather insights into local perspectives and experiences regarding this association. The systematic review revealed a consistent association between HDP and increased risk of PPD across various LMIC settings. Meta-analysis findings indicated a significant pooled odds ratio, highlighting a robust statistical linkage between HDP severity and subsequent PPD risk. Qualitative data underscored healthcare professionals' observations of heightened psychological distress among women with HDP, emphasizing the complex interplay between physiological complications and maternal mental health outcomes in the Ghanaian context. The study findings underscore the critical need for integrated maternal health strategies that address both physical and psychological aspects of pregnancy complications like HDP. By elucidating these connections, the study contributes to advancing evidence-based interventions and support systems tailored to LMIC settings, aiming to mitigate adverse maternal mental health outcomes and improve overall perinatal care in Ghana and similar contexts worldwide. These insights are pivotal for informing policy decisions, guiding healthcare practices, and fostering targeted interventions that enhance maternal well-being during the vulnerable perinatal period.
妊娠期高血压疾病（HDP）和产后抑郁症（PPD）是影响母婴健康的重大全球性健康挑战。HDP包括先兆子痫、妊娠期高血压和慢性高血压，在全球高达10%的妊娠中会出现并发症，对孕产妇死亡率有深远影响，尤其是在加纳等低收入和中等收入国家（LMIC）。HDP的发病率在全球范围内呈上升趋势，对孕产妇死亡以及死产和低出生体重等严重围产期结局有重大影响。与此同时，包括PPD在内的围产期心理健康问题影响着全球很大一部分女性，在低收入和中等收入国家的患病率更高。尽管已知HDP有生理影响，但其与孕产妇心理健康的关联仍未得到充分探索，尤其是在低收入和中等收入国家的背景下。我们进行了一项系统综述和荟萃分析，以探讨低收入和中等收入国家中HDP与PPD之间的关联，重点关注来自全球不同地区的现有文献和研究。此外还对加纳的医疗保健专业人员进行了半结构化定性访谈，以深入了解他们对这种关联的当地观点和经验。系统综述揭示了在各种低收入和中等收入国家环境中，HDP与PPD风险增加之间存在一致的关联。荟萃分析结果表明合并优势比显著，突出了HDP严重程度与随后的PPD风险之间存在强有力的统计联系。定性数据强调了医疗保健专业人员对患有HDP的女性心理困扰加剧的观察结果，强调了加纳背景下生理并发症与孕产妇心理健康结果之间的复杂相互作用。研究结果强调了迫切需要采取综合孕产妇健康策略，以解决像HDP这样的妊娠并发症的生理和心理方面问题。通过阐明这些联系，该研究有助于推进针对低收入和中等收入国家环境的循证干预措施和支持系统，旨在减轻孕产妇不良心理健康结果，并改善加纳及全球类似背景下的整体围产期护理。这些见解对于为政策决策提供信息、指导医疗实践以及促进有针对性的干预措施至关重要，这些干预措施可在脆弱的围产期增强孕产妇的福祉。
