Postpartum hemorrhage and postpartum depression: A systematic review and meta‐analysis of observational studies.
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| Title: | Postpartum hemorrhage and postpartum depression: A systematic review and meta‐analysis of observational studies. |
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| Authors: | Schoretsanitis, Georgios (AUTHOR), Gastaldon, Chiara (AUTHOR), Ochsenbein‐Koelble, Nicole (AUTHOR), Olbrich, Sebastian (AUTHOR), Barbui, Corrado (AUTHOR), Seifritz, Erich (AUTHOR) |
| Source: | Acta Psychiatrica Scandinavica. Nov2024, Vol. 150 Issue 5, p274-283. 10p. |
| Subjects: | Mental illness, Postpartum depression, Postpartum hemorrhage, Body mass index, Affective disorders |
| Abstract: | Objective: To assess the postpartum depression (PPD) risk in women with postpartum hemorrhage (PPH) and moderators. Methods: We identified observational studies of PPD rates in women with versus without PPH in Embase/Medline/PsychInfo/Cinhail in 09/2022. Study quality was evaluated using the Newcastle‐Ottawa‐Scale. Our primary outcome was the odds ratio (OR, 95% confidence intervals [95%CI]) of PPD in women with versus without PPH. Meta‐regression analyses included the effects of age, body mass index, marital status, education, history of depression/anxiety, preeclampsia, antenatal anemia and C‐section; subgroup analyses were based on PPH and PPD assessment methods, samples with versus without history of depression/anxiety, from low‐/middle‐ versus high‐income countries. We performed sensitivity analyses after excluding poor‐quality studies, cross‐sectional studies and sequentially each study. Results: One, five and three studies were rated as good‐, fair‐ and poor‐quality respectively. In nine studies (k = 10 cohorts, n = 934,432), women with PPH were at increased PPD risk compared to women without PPH (OR = 1.28, 95% CI = 1.13 to 1.44, p < 0.001), with substantial heterogeneity (I2 = 98.9%). Higher PPH‐related PPD ORs were estimated in samples with versus without history of depression/anxiety or antidepressant exposure (OR = 1.37, 95%CI = 1.18 to 1.60, k = 6, n = 55,212, versus 1.06, 95%CI = 1.04 to 1.09, k = 3, n = 879,220, p < 0.001) and in cohorts from low‐/middle‐ versus high‐income countries (OR = 1.49, 95%CI = 1.37 to 1.61, k = 4, n = 9197, versus 1.13, 95%CI = 1.04 to 1.23, k = 6, n = 925,235, p < 0.001). After excluding low‐quality studies the PPD OR dropped (1.14, 95%CI = 1.02 to 1.29, k = 6, n = 929,671, p = 0.02). Conclusions: Women with PPH had increased PPD risk amplified by history of depression/anxiety, whereas more data from low‐/middle‐income countries are required. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Objective: To assess the postpartum depression (PPD) risk in women with postpartum hemorrhage (PPH) and moderators. Methods: We identified observational studies of PPD rates in women with versus without PPH in Embase/Medline/PsychInfo/Cinhail in 09/2022. Study quality was evaluated using the Newcastle‐Ottawa‐Scale. Our primary outcome was the odds ratio (OR, 95% confidence intervals [95%CI]) of PPD in women with versus without PPH. Meta‐regression analyses included the effects of age, body mass index, marital status, education, history of depression/anxiety, preeclampsia, antenatal anemia and C‐section; subgroup analyses were based on PPH and PPD assessment methods, samples with versus without history of depression/anxiety, from low‐/middle‐ versus high‐income countries. We performed sensitivity analyses after excluding poor‐quality studies, cross‐sectional studies and sequentially each study. Results: One, five and three studies were rated as good‐, fair‐ and poor‐quality respectively. In nine studies (k = 10 cohorts, n = 934,432), women with PPH were at increased PPD risk compared to women without PPH (OR = 1.28, 95% CI = 1.13 to 1.44, p < 0.001), with substantial heterogeneity (I2 = 98.9%). Higher PPH‐related PPD ORs were estimated in samples with versus without history of depression/anxiety or antidepressant exposure (OR = 1.37, 95%CI = 1.18 to 1.60, k = 6, n = 55,212, versus 1.06, 95%CI = 1.04 to 1.09, k = 3, n = 879,220, p < 0.001) and in cohorts from low‐/middle‐ versus high‐income countries (OR = 1.49, 95%CI = 1.37 to 1.61, k = 4, n = 9197, versus 1.13, 95%CI = 1.04 to 1.23, k = 6, n = 925,235, p < 0.001). After excluding low‐quality studies the PPD OR dropped (1.14, 95%CI = 1.02 to 1.29, k = 6, n = 929,671, p = 0.02). Conclusions: Women with PPH had increased PPD risk amplified by history of depression/anxiety, whereas more data from low‐/middle‐income countries are required. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 0001690X |
| DOI: | 10.1111/acps.13583 |
