Prevalence, Symptoms, and Factors Associated with Postpartum Depression during the COVID-19 Pandemic; A Systematic Review

 Dr. Tabareeh Seif aldin^*

*Correspondence to: Dr. Tabareeh Seif aldin.

Copyright     

© 2024 Dr. Tabareeh Seif aldin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 7 November 2024

Published: 26 November 2024

DOI: https://doi.org/10.5281/zenodo.14222120

Background

Postpartum depression includes various depressive symptoms that affect mothers during the first year after delivery. The COVID-19 pandemic resulted in negative psychological impacts on all individuals, including women. There are several risk factors for postpartum depression, including the previous history of depression and lack of social support. The pandemic resulted in social distance and increased the of risk factors for depression.

Objectives

To determine the Prevalence, symptoms, and factors associated with postpartum depression during the COVID-19 pandemic; A systematic review.

Methodology

The medical literature was explored PubMed and Google scholar databases starting from 2020 till 2021. The included searching terms were a combination of "Postpartum and COVID-19, depression and COVID-19, PPD prevalence and COVID-19, PPD associated factors and COVID-19." The inclusion criteria were full-text, original articles that reported the prevalence and associated factors with postpartum depression during the COVID-19 pandemic.

Results

• The prevalence of postpartum depression ranged between 11.9% to 60.7%

• There were several risk factors and predictors for postpartum depression reported, and they included age, history of abortion perceived stress , older age, single status, unemployed, losing jobs due to pandemic, dissatisfaction with the household income , staying in COVID-19 suspect zone and COVID- 19 suspect status, concerns about the lack of hospital beds, absence of a partner, anxiety symptoms, educational level, visiting the doctor during quarantine, .Regarding COVID-19 impact, the studies reported similar impacts of COVID-19; one study reported there was a significant difference in the prevalence of depression between women with positive and those with negative COVID-19 test.

•Another study concluded that COVID-19 resulted in a high level of postpartum depression , the risk of nonpsychotic postpartum mood including postpartum depression was increased during the pandemic , the COVID-19 pandemic increased the prevalence of postpartum depression ,

•Another study also reported that the prevalence of postpartum depression was higher during COVID-19 pandemic compared to before the pandemic.

Discussion
• The outbreak of COVID-19 had many influences on humans; one of these effects is the impact of COVID-19 on mothers . Many maternal health challenges have been observed during the outbreak of COVID-19, with a higher prevalence of mental health problems reported among women.

• The COVID-19 pandemic has affected various maternal mental problems such as fear, irritability, loneliness, refusal to breastfeed, post-traumatic stress disorders , and mother-child attachment .

• So, it was necessary to investigate the impact of the COVID-19 pandemic on the prevalence and associated factors of PPD among women.

• It was found that the COVID-19 pandemic had a significant impact on the prevalence of PPD; this impact could be observed and confirmed by the findings reported by the studies, including the higher prevalence of PPD among women with positive COVID- 19 test compared to the prevalence of PPD among women with negative COVID- 19 test (42% Vs. 28%, respectively)

• The prevalence of PPD among women was higher in the COVID-19 pandemic compared with the prevalence during the duration before the pandemic.

• Moreover, the COVID-19 pandemic resulted not only in increased prevalence of PPD but also affected the psychological state of women, where the risk of nonpsychotic postpartum mood and anxiety disorders was increased among postpartum women during the pandemic.

• Although all the studies used one tool (EPDS) for assessing the risk of PPD and reported that the COVID-19 pandemic affects the psychological status of postpartum women negatively increased the risk and prevalence of PPD, it should be noted that studies determined variant Cut off for the risk of PPD; the cut off was determined at ≥9, ≥10, ≥12, and some studies didn’t even report the cut off they determined for assessing the risk of PPD.

• A study from Ethiopia reported a prevalence of 23.3% before the pandemic in 2016 . Although the prevalence rate reported from Ethiopia was in the prevalence range reported in our studies, it should be noted that the prevalence of a certain condition varies between countries, and the prevalence of PPD in Ethiopia may exceed the previous rates reported before the pandemic, and this may require a further investigation. Studies included in our review reported a significant increase in the prevalence of PPD due to the pandemic based on the previous rates reported from their countries of the studies.

• Regarding the factors associated with PPD or predictors of PPD among women during the COVID-19 pandemic, there were several factors reported in the included studies, including age, history of abortion, perceived stress, unemployed, losing a job due to pandemic, dissatisfaction with household income, staying in COVID-19 suspected zone, concern about lack of hospital beds, absence of a partner, anxiety symptoms, immigration, persistent fever, poor social support, marital status, concerns about contracting COVID-19, certain precautionary measures, education level, visiting the doctor during quarantine, diagnosis with depression, family history, and difficulties during childbirth during the pandemic.

• However, it is obvious in our studies of this review that there were other factors associated with the risk of PPD and were more related to the COVID- 19 pandemic, and they represented the majority of PPD predictors, whereas the risk factors of PPD that previously reported and known as predictors for PPD before the pandemic were less reported and prevalent among women. This indicates that COVID-19 added other risk factors for developing PPD

• other factors involved losing a job due to pandemic, staying in COVID-19 suspected zone, concern about lack of hospital beds, persistent fever, concerns about contracting COVID-19, certain precautionary measures, visiting the doctor during quarantine, and difficulties during childbirth during the pandemic.

Conclusion

The prevalence of PPD was increased due to the COVID-19 pandemic, as the pandemic resulted in additional risk factors for developing PPD. This shows the negative impact of COVID-19 on the psychological health of mothers that may, in turn, negatively affect their infant. So, continuous monitoring of the risk of PPD and diagnosis should be done to improve the outcomes of the mothers and their infants.

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