Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies
Br J Psychiatry. 2022 Jan 27;1-12. doi: 10.1192/bjp.2021.222 PDF costs $35
Chiara Gastaldon 1, Marco Solmi 2, Christoph U Correll 3, Corrado Barbui 4, Georgios Schoretsanitis 5
Background: Evidence on risk factors for postpartum depression (PPD) are fragmented and inconsistent.
Aims: To assess the strength and credibility of evidence on risk factors of PPD, ranking them based on the umbrella review methodology.
Method: Databases were searched until 1 December 2020, for systematic reviews and meta-analyses of observational studies. Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria.
Results: Including 185 observational studies (n = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81-2.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70-2.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35-1.75).
Following URC, the association was suggestive for
- Caesarean section (OR = 1.29, 95%CI 1.17-1.43),
- gestational diabetes (OR = 1.60, 95%CI 1.25-2.06) and
- 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57-0.86); and
weak for
- preterm delivery (OR = 2.12, 95%CI 1.43-3.14),
- anaemia during pregnancy (OR = 1.47, 95%CI 1.17-1.84),
- vitamin D deficiency (OR = 3.67, 95%CI 1.72-7.85) and
- postpartum anaemia (OR = 1.75, 95%CI 1.18-2.60).
No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as 'convincing evidence'. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and 'very low' for remaining factors.
Conclusions: The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. These results should be integrated in clinical algorithms to assess the risk of PPD.
VitaminDWiki articles in both Pregnancy AND Depression categories
- Post-partum depression and low Vitamin D - many studies
- Postpartum depression 3.6 X higher risk if low vitamin D – Jan 2022
- ADHD 3.7 X higher risk if depressed pregnancy (low vitamin D) – Dec 2020
- Depression after childbirth 5 X less likely if good Omega-3 index – April 2019
- Postpartum Depression 3.3 X more likely if low vitamin D – Oct 2018
- Vitamin D prevents pregnancy depression (US Prevention Task Force say it cannot be prevented) - Feb 2019
- Depressed black pregnant women should take vitamin D – April 2018
- Magnesium in Healthcare (Rickets, Stones, Pregnancy, Depression, etc.) with level of evidence – Sept 2017
- Perinatal depression decreased 40 percent with just a few weeks of 2,000 IU of vitamin D – RCT Aug 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Depression in youths associated with low vitamin D during pregnancy – Oct 2014
- Postpartum depression 7X more likely if less than 10 ng of vitamin D – Sept 2014
- Depression after pregnancy and vitamin D – Nov 2013
- Depression and Vitamin D during Pregnancy – Dissertation Aug 2014
- Depression during pregnancy twice as likely if consume little vitamin D – July 2014
- Antidepressants might increase infertility and pregnancy problems – Nov 2012
- Association between season of birth and suicide – perhaps vitamin D – Sept 2012
- Depression 50 percent more likely if low vitamin D in early pregnancy – Aug 2012
- Pregnant blacks 50 pcnt more likely to be depressed if 3 ng less vitamin D – July 2012
- Depressed mothers more likely to have small babies – Aug 2010
- An Exploratory Study of Postpartum Depression and Vitamin D - May 2010