Common perinatal mental disorders in women - A systematic review

There has been much more research into this topic in high income countries, where systematic reviews have found that in these settings approximately 10% of pregnant women and 13% of women who have given birth experience a mental health problem, usually depression or anxiety.

Key findings:

Lack of Evidence

Whilst there is much research on this topic in high income settings, there is very little evidence available from low and middle income countries.  80% of low and lower middle income countries (and 90% of the least developed countries) lack local evidence on common perinatal mental disorders. Only 8% of low and middle income countries had data on common mental disorders in pregnancy and only 15% had data on common mental disorders in the period after birth.

Higher Prevalence

In low- and lower-middle-income countries about one in six pregnant women (15.9%) and one in five women (19.8%) who have recently given birth experience a common perinatal mental disorder.

Risk factors for maternal mental health:

• having an unsupportive partner
• suffering from gender-based violence
• having difficult relationships with in-laws
• being socially disadvantaged
• having an unintended or unwanted pregnancy
• not having emotional or practical support from one’s mother
• in cultures favouring sons, having a daughter
• gender-based factors such as heavy unpaid workloads and restrictive roles for women

Protective factors for maternal mental health:

• being relatively socially and economically advantaged
• having more education
• having a permanent or secure job
• having an employed partner
• belonging to the ethnic majority
• having a supportive partner

Potential consequences of maternal mental health problems:

• suicide is one cause of maternal deaths
• stigma
• lower participation in antenatal, perinatal, postnatal (the periods before, during and after birth) and essential preventive health care
• infant development can be negatively affected if a mother is less responsive to or aware of her infant’s needs.  Maternal depression is linked with higher rates of malnutrition and stunting, diarrhoea, infectious diseases, hospital admissions, lower birth weight and reduced completion of immunization schedules among infants in low- and lower-middle-income countries.

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