Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis. (30th September 2020)

• Record Type: Journal Article
• Authors: Mahendran, R; Puthussery, S; Amalan, M
• Is Part Of: European journal of public health. Volume 30:Number 5(2020)
• Publication Date: 2020-09-30
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckaa165.557
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Background: Antenatal depression carries significant adverse implications for the health and well-being of women, babies and their families. While prevalence of perinatal mental disorders in low-and lower-middle-income countries tends to be higher compared to high-income countries, rates tend to vary widely among countries in certain regions such as South Asia. This study estimated the pooled prevalence of antenatal depression in South Asia and examined variations in individual countries. Methods: We conducted a systematic review and meta-analysis. A comprehensive search was conducted on thirteen electronic databases and grey sources for articles published between 1·1·2007 and 31·5·2018 from South Asian countries including Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. Studies reporting quantitative prevalence estimates of antenatal depression using a validated diagnostic/ screening tool identified, screened and appraised using a two-stage process. A meta-analysis was conducted using the proportion (%) of pregnant women identified as having antenatal depression as the primary outcome. Results: Thirty-three studies involving 13, 087 pregnant women were included in the meta-analysis. Overall pooled prevalence was 24·57% (95% CI: 19·34, 30·69). Prevalence rates for India (17·74%, 95% CI: 11·19, 26·96) and Sri Lanka (15·87%, 95% CI: 14·04, 17·88) were lower compared to the overall prevalence whereas the rates for Pakistan (32·2%, 95% CI: 23·11, 42·87) and Nepal (50%, 95% CI: 35·64, 64·36) were higher. Conclusions: While robust prevalence studies are sparse in most South Asian countries, one in four pregnant women is likely to experience antenatal depression in the region. The issue needs to be recognised in health policy and practice for resource allocation and capacity building at regional and national levels for prevention, diagnosis and treatment. Key messages: One in four pregnant women is likely to experience antenatal depression in South Asia region. Targeted efforts are needed at national and regional levels for prevention, diagnosis and treatment.