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Published in: Archives of Women's Mental Health 2/2019

01-04-2019 | Original Article

Postpartum depressive mood (PDM) among Chinese women: a meta-analysis

Authors: Ting-Yu Mu, Yu-Hong Li, Hai-Feng Pan, Liu Zhang, Da-Hui Zha, Cheng-Lu Zhang, Ri-Xiang Xu

Published in: Archives of Women's Mental Health | Issue 2/2019

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Abstract

Postpartum depression is a common complication of childbearing and up to 12 months postpartum. This study aimed to determine the prevalence of postpartum depressive mood (PDM) in China by performing a meta-analysis of published studies. Studies that reported the prevalence of PDM in China were identified by searching the PubMed, Embase, CNKI, and CQVIP databases. Three thousand, one hundred, and two articles were obtained, and after careful evaluation, 26 studies were finally included in the meta-analysis. The combined studies included a total of 7618 cases with 1621 cases of PDM. The studies were assessed on the basis of heterogeneity testing and the potential for publication bias. Stata software 11.0 was used to perform the meta-analysis. The random-effect model showed that the prevalence of PDM was 21% with a 95% confidence interval (CI) of 17–25%. PDM was the highest 0 to 1.5 months after delivery. PDM levels decreased to 10.4% (95% CI 9.7–11.1%, P < 0.001) after publication bias were corrected. Sensitivity analyses evaluated the stability of our results and showed no significant change when any single study was excluded. Subgroup analyses showed that region, instruments used, cut-off score, and time points for depression assessment were positively associated with PDM prevalence. The prevalence of PDM differed among regions, with South Central China and East China exhibiting the lowest prevalence. The prevalence was higher in regions with poor economic development, suggesting that more attention should be devoted to Southwest and North China and that the prevalence of PDM should be evaluated 0 to 1.5 months after delivery.
Literature
go back to reference Adouard F, Glangeaud-Freudenthal N-M-C, Golse B (2005) Validation of the Edinburgh postnatal depression scale (EPDS) in a sample of women with high-risk pregnancies in France. Arch Womens Ment Health 8:89–95CrossRefPubMed Adouard F, Glangeaud-Freudenthal N-M-C, Golse B (2005) Validation of the Edinburgh postnatal depression scale (EPDS) in a sample of women with high-risk pregnancies in France. Arch Womens Ment Health 8:89–95CrossRefPubMed
go back to reference Alligood M-R (2013) Nursing theorists and their work, 8th edn. Elsevier Medicine, Amsterdam, pp 743–761 Alligood M-R (2013) Nursing theorists and their work, 8th edn. Elsevier Medicine, Amsterdam, pp 743–761
go back to reference American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5thedition. American Psychiatric Association, Washington, DCCrossRef American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5thedition. American Psychiatric Association, Washington, DCCrossRef
go back to reference Beck CT (1993) Teetering on the edge: a substantive theory of postpartum depression. Nurs Res 42:42–48CrossRefPubMed Beck CT (1993) Teetering on the edge: a substantive theory of postpartum depression. Nurs Res 42:42–48CrossRefPubMed
go back to reference Cameron EE, Sedov ID, Tomfohr-Madsen LM (2016) Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis. J Affect Disord 206:189–203CrossRefPubMed Cameron EE, Sedov ID, Tomfohr-Madsen LM (2016) Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis. J Affect Disord 206:189–203CrossRefPubMed
go back to reference Cox J-L, Sagovsky R (1987) Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 50:782–786CrossRef Cox J-L, Sagovsky R (1987) Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 50:782–786CrossRef
go back to reference Gavin N-I, Gaynes B-N, Lohr K-N, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083CrossRefPubMed Gavin N-I, Gaynes B-N, Lohr K-N, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083CrossRefPubMed
go back to reference Gaynes B-N, Gavin N, Meltzer-Brody S et al (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess 119:1–8 Gaynes B-N, Gavin N, Meltzer-Brody S et al (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess 119:1–8
go back to reference Klainin P, Arthur D-G (2009) Postpartum depression in Asian cultures: a literature review. Int J Nurs Stud 46:1355–1373CrossRefPubMed Klainin P, Arthur D-G (2009) Postpartum depression in Asian cultures: a literature review. Int J Nurs Stud 46:1355–1373CrossRefPubMed
go back to reference Lee D-T-S, Yip SK, Chiu H-F-K, Leung TYS, Chan KPM, Chau IOL, Leung HCM, Chung TKH (1998) Detecting postnatal depression in Chinese women validation of Chinese version of the Edinburgh postnatal depression scale. Br J Psychiatry 172:433–437CrossRefPubMed Lee D-T-S, Yip SK, Chiu H-F-K, Leung TYS, Chan KPM, Chau IOL, Leung HCM, Chung TKH (1998) Detecting postnatal depression in Chinese women validation of Chinese version of the Edinburgh postnatal depression scale. Br J Psychiatry 172:433–437CrossRefPubMed
go back to reference Lee D-T, Chiu H et al (2006) A psychiatric epidemiological study of postpartum Chinese women. Am J Psychiatry 158:220–226CrossRef Lee D-T, Chiu H et al (2006) A psychiatric epidemiological study of postpartum Chinese women. Am J Psychiatry 158:220–226CrossRef
go back to reference Li Y-H, Fu S-L et al (2009) Survey on the status of depression in puerpera and her spouse during the puerperium [in Chinese]. Acta Univ Med Anhui 44:506–508 Li Y-H, Fu S-L et al (2009) Survey on the status of depression in puerpera and her spouse during the puerperium [in Chinese]. Acta Univ Med Anhui 44:506–508
go back to reference Luo Y, He G-P (2007) Correlative analysis of postpartum depression[in Chinese]. J Cent South Univ 32:460–464 Luo Y, He G-P (2007) Correlative analysis of postpartum depression[in Chinese]. J Cent South Univ 32:460–464
go back to reference Ma X-H, Song F-L et al (2017) Study of the Edinburgh postnatal depression scale in the screening of postpartum depression [in Chinese]. Chinese J Med 2:52–57 Ma X-H, Song F-L et al (2017) Study of the Edinburgh postnatal depression scale in the screening of postpartum depression [in Chinese]. Chinese J Med 2:52–57
go back to reference Mandelli L, Souery D, Bartova L (2016) Bipolar II disorder as a risk factor for postpartum depression. J Affect Disord 204:54–58CrossRefPubMed Mandelli L, Souery D, Bartova L (2016) Bipolar II disorder as a risk factor for postpartum depression. J Affect Disord 204:54–58CrossRefPubMed
go back to reference Matthey S, Barnett B, Kavanagh DJ, Howie P (2001) Validation of the Edinburgh postnatal depression scale for men, and comparison of item endorsement with their partners. J Affect Disord 64:175–184CrossRefPubMed Matthey S, Barnett B, Kavanagh DJ, Howie P (2001) Validation of the Edinburgh postnatal depression scale for men, and comparison of item endorsement with their partners. J Affect Disord 64:175–184CrossRefPubMed
go back to reference O’Hara M, Swain A (1996) Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54CrossRef O’Hara M, Swain A (1996) Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54CrossRef
go back to reference Palma S, Delgado-Rodriguez M (2005) Assessment of publication bias in meta-analyses of cardiovascular diseases. J Epidemiol Community Health 59:864–869CrossRefPubMedPubMedCentral Palma S, Delgado-Rodriguez M (2005) Assessment of publication bias in meta-analyses of cardiovascular diseases. J Epidemiol Community Health 59:864–869CrossRefPubMedPubMedCentral
go back to reference Qian Y-R, Yan X (2013) Prevalence of postpartum depression in China: a systematic analysis [in Chinese]. Chinese J Pract Nurs 29:1–3 Qian Y-R, Yan X (2013) Prevalence of postpartum depression in China: a systematic analysis [in Chinese]. Chinese J Pract Nurs 29:1–3
go back to reference Robert K, Pages C, Ledru A et al (2005) Regulation of extracellular signal-regulated kinase by homocysteine in hippocampus. Neuroscience 133:925–935CrossRefPubMed Robert K, Pages C, Ledru A et al (2005) Regulation of extracellular signal-regulated kinase by homocysteine in hippocampus. Neuroscience 133:925–935CrossRefPubMed
go back to reference Tao P, Lian W et al (1994) EPDS in postpartum depression screening [in Chinese]. Chin Ment Health J 8:18–19 Tao P, Lian W et al (1994) EPDS in postpartum depression screening [in Chinese]. Chin Ment Health J 8:18–19
go back to reference Tian L-J, Li C-X, Man D-M (2014) The effect of sopfrology childbirth method training, Kegel training and Lamaze respiratory training on depression and sexual life of perinatal pregnant woman [in Chinese]. Chin J Behav Med Brain Sci 23:344–347 Tian L-J, Li C-X, Man D-M (2014) The effect of sopfrology childbirth method training, Kegel training and Lamaze respiratory training on depression and sexual life of perinatal pregnant woman [in Chinese]. Chin J Behav Med Brain Sci 23:344–347
go back to reference Wang T-T, Xu Y, Li Z-Z et al (2016) Prevalence of paternal postpartum depression in China and its association with maternal postpartum depression [in Chinese]. J Cent South Univ 10:1082–1089 Wang T-T, Xu Y, Li Z-Z et al (2016) Prevalence of paternal postpartum depression in China and its association with maternal postpartum depression [in Chinese]. J Cent South Univ 10:1082–1089
go back to reference Gao L-L, Chan S-W, Mao Q (2009) Depression, perceived stress, and social support among first-time Chinese mothers and fathers in the postpartum period. Res Nurs Health 32:50–58CrossRefPubMed Gao L-L, Chan S-W, Mao Q (2009) Depression, perceived stress, and social support among first-time Chinese mothers and fathers in the postpartum period. Res Nurs Health 32:50–58CrossRefPubMed
go back to reference Guo X-J, Liu Y, Wang Y-Q et al (2013) The association between postnatal depression symptoms and parent-in-law conflicts. Pract J Clin Med 10:36–38 [In Chinese] Guo X-J, Liu Y, Wang Y-Q et al (2013) The association between postnatal depression symptoms and parent-in-law conflicts. Pract J Clin Med 10:36–38 [In Chinese]
go back to reference He Y (2008) The study of the risk factors and cognition function lesion of postpartum depression in parturient women in Changsha City. Dissertation, Central South University of China. [In Chinese] He Y (2008) The study of the risk factors and cognition function lesion of postpartum depression in parturient women in Changsha City. Dissertation, Central South University of China. [In Chinese]
go back to reference He J, Shang-guan J-X, Wang H-P (2000) Clinical study on postpartum depression and its related factors. Chin J Obstet Gynecol 35:660–663 [In Chinese] He J, Shang-guan J-X, Wang H-P (2000) Clinical study on postpartum depression and its related factors. Chin J Obstet Gynecol 35:660–663 [In Chinese]
go back to reference He P, Huang Y, Lu M et al (2014) Analysis on gestational and postpartum psychological statuses and influencing factors in 419 pregnant women. Matern Child Health Care China 23:3731–3735 [In Chinese] He P, Huang Y, Lu M et al (2014) Analysis on gestational and postpartum psychological statuses and influencing factors in 419 pregnant women. Matern Child Health Care China 23:3731–3735 [In Chinese]
go back to reference Hu S-J, Gu R-J, Xu G-H (2001) Investigation on depression, anxiety situation before and after childbirth of 76 first lying—in women. Health Psychol J 9:464–465 [In Chinese] Hu S-J, Gu R-J, Xu G-H (2001) Investigation on depression, anxiety situation before and after childbirth of 76 first lying—in women. Health Psychol J 9:464–465 [In Chinese]
go back to reference Jin J-Z (2008) Investigation and analysis of postpartum depression status and its influence factors in YanBian Area. Dissertation, Yanbian University of China. [In Chinese] Jin J-Z (2008) Investigation and analysis of postpartum depression status and its influence factors in YanBian Area. Dissertation, Yanbian University of China. [In Chinese]
go back to reference Li Z-M, Liu X-Q, Chen Y-P et al (2010) Research of mothers and their spouses depression condition. J Pract Med 26:3244–3246 [In Chinese] Li Z-M, Liu X-Q, Chen Y-P et al (2010) Research of mothers and their spouses depression condition. J Pract Med 26:3244–3246 [In Chinese]
go back to reference Liang X-H, Hu D-G, Yang B-F (2007) Analysis of logistic regression of anxiety and depression for postpartum. Chin J Behav Med Brain Sci 16:511–512 [In Chinese] Liang X-H, Hu D-G, Yang B-F (2007) Analysis of logistic regression of anxiety and depression for postpartum. Chin J Behav Med Brain Sci 16:511–512 [In Chinese]
go back to reference Liu L-F, Zhao G-F, Hou R-H et al (2002) Links between early maternity blues and post-natal depression. Chin J Behav Med Brain Sci 11:167–169 [In Chinese] Liu L-F, Zhao G-F, Hou R-H et al (2002) Links between early maternity blues and post-natal depression. Chin J Behav Med Brain Sci 11:167–169 [In Chinese]
go back to reference Liu Y-Q, Judith A, Marcia A et al (2014) Effect of postpartum practices of doing the month on Chinese women’s physical and psychological health. Biol Res Nurs 16:55–63CrossRefPubMed Liu Y-Q, Judith A, Marcia A et al (2014) Effect of postpartum practices of doing the month on Chinese women’s physical and psychological health. Biol Res Nurs 16:55–63CrossRefPubMed
go back to reference Mao Q, Zhu L-X, Su X-Y (2011) A comparison of postnatal depression and related factors between Chinese new mothers and fathers. J Clin Nurs 20:645–652CrossRefPubMed Mao Q, Zhu L-X, Su X-Y (2011) A comparison of postnatal depression and related factors between Chinese new mothers and fathers. J Clin Nurs 20:645–652CrossRefPubMed
go back to reference Ngai F-W, Chan S-W (2012) Learned resourcefulness, social support, and perinatal depression in Chinese mothers. Nurs Res 61:78–85CrossRefPubMed Ngai F-W, Chan S-W (2012) Learned resourcefulness, social support, and perinatal depression in Chinese mothers. Nurs Res 61:78–85CrossRefPubMed
go back to reference Ngai F-W, Ngu S-F (2015) Predictors of maternal and paternal depressive symptoms at postpartum. J Psychosom Res 78:156–161CrossRefPubMed Ngai F-W, Ngu S-F (2015) Predictors of maternal and paternal depressive symptoms at postpartum. J Psychosom Res 78:156–161CrossRefPubMed
go back to reference Nv L-J, Zou X-R, Chen X-Y (2006) Investigation to factors related to post-parturition depression. J Huaihai Med 24:273–275 [In Chinese] Nv L-J, Zou X-R, Chen X-Y (2006) Investigation to factors related to post-parturition depression. J Huaihai Med 24:273–275 [In Chinese]
go back to reference Qiu J-Y, Wang Z-C, Xie B et al (2001) A prospective study of postpartum depression: biological and psychosocial factors. Chin J Nerv Ment Dis 27:26–28 [In Chinese] Qiu J-Y, Wang Z-C, Xie B et al (2001) A prospective study of postpartum depression: biological and psychosocial factors. Chin J Nerv Ment Dis 27:26–28 [In Chinese]
go back to reference Sun H-L, Su H, Zhang J, Fan W (2015) Analysis of correlation factors of postpartum depression. J Kunming Med Univ 36:60–64 [In Chinese] Sun H-L, Su H, Zhang J, Fan W (2015) Analysis of correlation factors of postpartum depression. J Kunming Med Univ 36:60–64 [In Chinese]
go back to reference Wang X-N, Wu H-N (2014) Correlation analysis of perceived stress and postpartum depression of delivery women in a hospital in Taizhou, Zhejiang. Med Soc 27:77–79 [In Chinese] Wang X-N, Wu H-N (2014) Correlation analysis of perceived stress and postpartum depression of delivery women in a hospital in Taizhou, Zhejiang. Med Soc 27:77–79 [In Chinese]
go back to reference Wang X, Yuan Y, Liu J-A (2009) An explore of postpartum depression level and risk factors. China J Health Psychol 17:89–91 [In Chinese] Wang X, Yuan Y, Liu J-A (2009) An explore of postpartum depression level and risk factors. China J Health Psychol 17:89–91 [In Chinese]
go back to reference Yang H-A, Song G-L, Li R-P et al (2009) Study on influence of social support and family function on postpartum depression feeling. Chin Nurs Res 23:3126–3128 [In Chinese] Yang H-A, Song G-L, Li R-P et al (2009) Study on influence of social support and family function on postpartum depression feeling. Chin Nurs Res 23:3126–3128 [In Chinese]
go back to reference Yu J (2010) The study of postpartum depression in shanghai. Dissertation, Fudan University of China. [In Chinese] Yu J (2010) The study of postpartum depression in shanghai. Dissertation, Fudan University of China. [In Chinese]
go back to reference Zhang H-W, Zhou P, Liu L-Q et al (2014) Analysis of relevant factors of postpartum depression in rural primiparas. Med J Chin People’s Health 26:1–5 [In Chinese] Zhang H-W, Zhou P, Liu L-Q et al (2014) Analysis of relevant factors of postpartum depression in rural primiparas. Med J Chin People’s Health 26:1–5 [In Chinese]
go back to reference Zhang L, Li Y-H, Bu Y-G et al (2015) Dynamic observation of female perinatal depression and study on the related factors. Matern Child Health Care China 15:2393–2397 [In Chinese] Zhang L, Li Y-H, Bu Y-G et al (2015) Dynamic observation of female perinatal depression and study on the related factors. Matern Child Health Care China 15:2393–2397 [In Chinese]
go back to reference Zhao B-L, Zhao Y, Fang J (2008) A survey of antepartum and postpartum women with depression and anxiety. J Clin Psychiatry 18:105–106 [In Chinese] Zhao B-L, Zhao Y, Fang J (2008) A survey of antepartum and postpartum women with depression and anxiety. J Clin Psychiatry 18:105–106 [In Chinese]
go back to reference Zhao Y, Zhao B-L, Ying X, Fang M et al (2011) Investigation of mental states of 201 women in pregnant and postpartum periods. J Clin Psychiatry 21:18–20 [In Chinese] Zhao Y, Zhao B-L, Ying X, Fang M et al (2011) Investigation of mental states of 201 women in pregnant and postpartum periods. J Clin Psychiatry 21:18–20 [In Chinese]
go back to reference Zhong H, Wei X-F (2009) Maternal anxiety and depression condition investigation before and after childbirth. Physicians association psychiatrist branch of ZheJiang province second annual meeting 236–239. [In Chinese] Zhong H, Wei X-F (2009) Maternal anxiety and depression condition investigation before and after childbirth. Physicians association psychiatrist branch of ZheJiang province second annual meeting 236–239. [In Chinese]
Metadata
Title
Postpartum depressive mood (PDM) among Chinese women: a meta-analysis
Authors
Ting-Yu Mu
Yu-Hong Li
Hai-Feng Pan
Liu Zhang
Da-Hui Zha
Cheng-Lu Zhang
Ri-Xiang Xu
Publication date
01-04-2019
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health / Issue 2/2019
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-018-0885-3

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