A systematic review and meta-regression of the prevalence and incidence of perinatal depression

Woody, C. A., Ferrari, A. J., Siskind, D. J., Whiteford, H. A. and Harris, M. G. (2017) A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, 219 86-92. doi:10.1016/j.jad.2017.05.003

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Author Woody, C. A.
Ferrari, A. J.
Siskind, D. J.
Whiteford, H. A.
Harris, M. G.
Title A systematic review and meta-regression of the prevalence and incidence of perinatal depression
Journal name Journal of Affective Disorders   Check publisher's open access policy
ISSN 1573-2517
0165-0327
Publication date 2017-09-01
Year available 2017
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jad.2017.05.003
Open Access Status File (Author Post-print)
Volume 219
Start page 86
End page 92
Total pages 7
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Language eng
Subject 3203 Clinical Psychology
2738 Psychiatry and Mental health
Abstract Background Major Depressive Disorder (MDD) is a leading cause of the disease burden for women of childbearing age, but the burden of MDD attributable to perinatal depression is not yet known. There has been little effort to date to systematically review available literature and produce global estimates of prevalence and incidence of perinatal depression. Enhanced understanding will help to guide resource allocation for screening and treatment. Methods A systematic literature review using the databases PsycINFO and PubMED returned 140 usable prevalence estimates from 96 studies. A random-effects meta-regression was performed to determine sources of heterogeneity in prevalence estimates between studies and to guide a subsequent random-effects meta-analysis. Results The meta-regression explained 31.1% of the variance in prevalence reported between studies. Adjusting for the effects of all other variables in the model, prevalence derived using symptom scales was significantly higher than prevalence derived using diagnostic instruments (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.3–2.0). Additionally, prevalence was significantly higher in women from low and middle income countries compared to women from high income countries (OR 1.8, 95% CI 1.4–2.2). The overall pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4–12.5). There were insufficient data to calculate pooled incidence. Limitations Studies in low income countries were especially scarce in this review, demonstrating a need for more epidemiological research in those regions. Conclusions Perinatal depression appears to impose a higher burden on women in low- and middle-income countries. This review contributes significantly to the epidemiological literature on the disorder.
Formatted abstract
Background

Major Depressive Disorder (MDD) is a leading cause of the disease burden for women of childbearing age, but the burden of MDD attributable to perinatal depression is not yet known. There has been little effort to date to systematically review available literature and produce global estimates of prevalence and incidence of perinatal depression. Enhanced understanding will help to guide resource allocation for screening and treatment.

Methods

A systematic literature review using the databases PsycINFO and PubMed returned 140 usable prevalence estimates from 96 studies. A random-effects meta-regression was performed to determine sources of heterogeneity in prevalence estimates between studies and to guide a subsequent random-effects meta-analysis.

Results

The meta-regression explained 31.1% of the variance in prevalence reported between studies. Adjusting for the effects of all other variables in the model, prevalence derived using symptom scales was significantly higher than prevalence derived using diagnostic instruments (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.3–2.0). Additionally, prevalence was significantly higher in women from low and middle income countries compared to women from high income countries (OR 1.8, 95% CI 1.4–2.2). The overall pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4–12.5). There were insufficient data to calculate pooled incidence.

Limitations

Studies in low income countries were especially scarce in this review, demonstrating a need for more epidemiological research in those regions.

Conclusions

Perinatal depression appears to impose a higher burden on women in low- and middle-income countries. This review contributes significantly to the epidemiological literature on the disorder.
Keyword Epidemiology
Meta-regression
Perinatal depression
Prevalence
Systematic review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
Faculty of Medicine
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