AUTHOR=Zhang Xiaoqian , Wang Chun , Zuo Xiaoli , Aertgeerts Bert , Buntinx Frank , Li Tang , Vermandere Mieke 

TITLE=Study characteristical and regional influences on postpartum depression before vs. during the COVID-19 pandemic: A systematic review and meta-analysis

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1102618

DOI=10.3389/fpubh.2023.1102618

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>While the public is under serious pressure from the coronavirus disease 2019 (COVID-19), the final impact and possible contributing factors to postpartum depression symptoms (PPDS) remain unknown. Therefore, a meta-analysis to investigate the association between PPDS and the COVID-19 pandemic was carried out by comparing the data between pre-pandemic and post-pandemic timeframes and exploring the influencing factors.</p></sec><sec><title>Methods</title><p>This systematic review was prospectively registered and recorded in a study protocol (Prospero CRD42022336820, <ext-link ext-link-type="uri" xlink:href="http://www.crd.york.ac.uk/PROSPERO" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.crd.york.ac.uk/PROSPERO</ext-link>). A comprehensive search of PubMed, Embase, Web of Science, CINALH, Cochrane and Scopus was cmpleted on June 6, 2022. Studies that compared the prevalence of PPD before and during the COVID-19 pandemic period were included.</p></sec><sec><title>Results</title><p>Of 1766 citations identified, 22 studies were included with 15,098 participates before the COVID-19 pandemic and 11,836 participants during the COVID-19 pandemic. Overall, the analysis showed that the epidemic crisis was associated with an increased prevalence of PPDS (OR: 0.81 [0.68, 0.95], <italic>P</italic> = 0.009, <italic>I</italic><sup>2</sup> = 59%). Subgroup analysis was conducted according to the study characteristics and regions. Within the study characteristics classification, results showed an obvious increase in the prevalence of PPDS during the COVID-19 pandemic if PPDS cutoff was defined as Edinburgh postpartum depression score (EPDS) ≥13 points (OR: 0.72 [0.52, 0.98], <italic>P</italic> = 0.03, <italic>I</italic><sup>2</sup> = 67%) and an increased prevalence in follow-ups that happened after 2 weeks (≥ 2 weeks postpartum) (OR: 0.81 [0.68, 0.97], <italic>P</italic> = 0.02, <italic>I</italic><sup>2</sup> = 43%). Selected studies that were high-quality (OR: 0.79 [0.64, 0.97], <italic>P</italic> = 0.02, <italic>I</italic><sup>2</sup> = 56%) demonstrated an increased prevalence of PPDS during the COVID-19 pandemic period. Sorting by regional factors, studies conducted in Asia (OR: 0.81 [0.70, 0.93], <italic>P</italic> = 0.003, <italic>I</italic><sup>2</sup> = 0%) showed an increase of PPDS prevalence rates during the COVID-19 period, while studies conducted in Europe (OR: 0.82 [0.59, 1.13], <italic>P</italic> = 0.23, <italic>I</italic><sup>2</sup> = 71%) and North America (OR: 0.66 [0.42, 1.02], <italic>P</italic> = 0.06, <italic>I</italic><sup>2</sup> = 65%) showed no significant difference. All studies conducted in the developed (OR: 0.79 [0.64, 0.98], <italic>P</italic> = 0.03, <italic>I</italic><sup>2</sup> = 65%) and developing countries (OR: 0.81 [0.69, 0.94], <italic>P</italic> = 0.007, <italic>I</italic><sup>2</sup> = 0%) showed an increase of PPDS during the COVID-19 period.</p></sec><sec><title>Conclusions</title><p>The COVID-19 pandemic is associated with an increased prevalence of PPDS, especially after long-term follow-up and among the group with a high possibility of depression. The negative influence from the pandemic, causing more PPDS was significant in studies from Asia.</p></sec>