Cited by 1,055Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

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Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis

Shorey, Shefaly, Chee, Cornelia Yin Ing, Ng, Esperanza Debby, Chan, Yiong Huak, Tam, Wilson Wai San, Chong, Yap Seng·2018·Journal of Psychiatric Research

DOI 10.1016/j.jpsychires.2018.08.001

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Abstract

This review aims to examine the prevalence and incidence of postpartum depression among healthy mothers without prior history of depression including postpartum depression and who gave birth to healthy full-term infants. A systematic search of ClinicalTrials.gov, CINAHL, EMBASE, PsycINFO, and PubMed was performed for English articles from the inception of the database to November 2017, as well as a manual search of the reference lists of the included articles, and an expert panel was consulted. Across 15,895 articles, 58 articles (N = 37,294 women) were included in the review. The incidence of postpartum depression was 12% [95% CI 0.04-0.20] while the overall prevalence of depression was 17% [95% CI 0.15-0.20] among healthy mothers without a prior history of depression. Prevalence was similar regardless of the type of diagnostic tool used; however, there were statistical differences in the prevalence between different geographical regions, with the Middle-East having the highest prevalence (26%, 95% CI 0.13-0.39) and Europe having the lowest (8%, 95% CI 0.05-0.11). There was no statistical difference in prevalence between different screening time points, but an increasing prevalence was observed beyond six months postpartum. Intervention studies often neglect healthy mothers. This review reports a similar prevalence rate of postpartum depression among mothers without history of depression when compared to mothers with history of depression. Thus, future studies should place equal emphasis on this neglected group of mothers so that targeted interventions and follow-ups can be introduced at appropriate time points.

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Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression
Kiewa, J., Meltzer-Brody, S. E., Milgrom, J., Bennett, E., Mackle, T., Guintivano, J., Hickie, I. B., Colodro‐Conde, L., Medland, S. E., Martin, N., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-059300 · Cited by 16
‘Next Stop: Mum’: Evaluation of a Postpartum Depression Prevention Strategy in Poland
Chrzan‐Dętkoś, M., Murawska, N., & Walczak‐Kozłowska, T. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811731 · Cited by 14
“If PPD is left untreated, the symptoms last seven months on average, but they can extend into the second year after giving birth [5].”
Background
Cognitive processing of infant stimuli in pregnant women with and without affective disorders and the association to postpartum depression
Bjertrup, A. J., Jensen, M. B., Schjødt, M. S., Parsons, C. E., Kjærbye‐Thygesen, A., Mikkelsen, R. L., Moszkowicz, M., Frøkjær, V. G., Vinberg, M., Kessing, L. V., et al. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.10.006 · Cited by 14
Canadian women’s experience of postnatal care: a mixed method study
Dol, J., Hughes, B., Tomblin Murphy, G., Aston, M., McMillan, D., & Campbell-Yeo, M. (2022) · Canadian Journal of Nursing Research · doi:10.1177/08445621211052141 · Cited by 15
“lenges in the postpartum period (Shorey et al., 2018), in”
Background
Trends in prevalence and treatment of antepartum and postpartum depression in the United States: Data from the national health and nutrition examination survey (NHANES) 2007 to 2018
Gardner, R. M., Sultan, P., Bernert, R. A., & Simard, J. F. (2025) · PLoS ONE · doi:10.1371/journal.pone.0322536 · Cited by 14
“Postpartum depression is the most common pregnancy-related complication worldwide and can lead to adverse maternal and child outcomes, including compromised mother-infant bonding, poorer infant cognitive outcomes, and shorter breastfeeding duration [1–4].”
Improving access to perinatal mental health services: the value of on-site resources
Rodriguez, A. N., Holcomb, D. S., Fleming, E. T., Faucher, M. A., Dominguez, J., Corona, R., McIntire, D. D., & Nelson, D. B. (2021) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2021.100456 · Cited by 13
Pelvic floor dysfunction in rural postpartum mothers in the United States: prevalence, severity, and psychosocial correlates
Snyder, K., Mollard, E. K., Bargstadt-Wilson, K., Peterson, J., Branscum, C., & Richards, T. N. (2022) · Women & Health · doi:10.1080/03630242.2022.2146831 · Cited by 13
Structural and functional improvement of amygdala sub-regions in postpartum depression after acupuncture
Huang, X.-X., Zhuo, Y., Wang, X.-R., Xu, J., Yang, Z.-X., Zhou, Y.-M., Lv, H., Ma, X.-M., Yan, B., Zhao, H., et al. (2023) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2023.1163746 · Cited by 12
“The global prevalence of PPD is 12–19% (Bener et al., 2012; Shorey et al., 2018).”
Background
Depression and diet‐related distress among Japanese women with gestational diabetes mellitus
Yamada, K., Endo, M., & Ohashi, K. (2023) · Nursing and Health Sciences · doi:10.1111/nhs.13054 · Cited by 18
“In recent years, the importance of perinatal mental health has been recognized, and international reviews have reported that the incidence of depression in pregnancy and the postpartum period is 17% and 12% – 13%, respectively (Shorey et al., 2018; Underwood et al., 2016).”
Postpartum symptoms of anxiety, depression and stress: differential relationships to women’s cortisol profiles
Weiss, S. J., & Xu, L. (2024) · Archives of Women s Mental Health · doi:10.1007/s00737-024-01421-9 · Cited by 21
“The overall prevalence of postpartum depression is approximately 17% among healthy mothers without a prior history of depression (Shorey et al. 2018), while postpartum anxiety ranges from 8.5–15% (Dennis et al. 2017; Goodman et al. 2016).”
BackgroundInfluential
Developmental trajectories of the default mode, frontoparietal, and salience networks from the third trimester through the newborn period
Scheinost, D., Chang, J. T., Brennan‐Wydra, E., Lacadie, C., Constable, R. T., Chawarska, K., & Ment, L. R. (2024) · Imaging Neuroscience · doi:10.1162/imag_a_00201 · Cited by 17
“…of the cohort exceeded the cutoff point of 11 on the EPDS, demonstrating that the prevalence of elevated symptoms of depression and anxiety in our sample was consistent with the prepandemic estimates observed in the general population ( Dennis et al., 2017; Levis et al., 2020; Shorey et al., 2018).”
Result
Preventive interventions for perinatal mood and anxiety disorders: A review of selected programs
Werner, E. A., Le, H., Babineau, V., & Grubb, M. D. (2024) · Seminars in Perinatology · doi:10.1016/j.semperi.2024.151944 · Cited by 13
The influence of social support in the prevention and treatment of postpartum depression: An intervention-based narrative review
Norazman, C. W., & Lee, L. K. (2024) · Women s Health · doi:10.1177/17455057241275587 · Cited by 28
Inflammatory signalling during the perinatal period: Implications for short- and long-term disease risk
de leon, R. G., Hodges, T. E., Brown, H. K., Bodnar, T. S., & Galea, L. A. M. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107245 · Cited by 15
Marriage and postpartum major depressive disorder: A systematic review and meta-analysis of cohort studies
Wei, M., Qin, Y., Niu, X., Niu, S., Mu, F., Yang, L., Li, Y., Zhang, Y., Wang, J., & Liu, Y. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.01.004 · Cited by 23
Lifetime traumatic experiences and postpartum depressive symptoms in a cohort of women in South India
Patil, D. M., Bajaj, A., Supraja, T. A., Chandra, P. S., & Satyanarayana, V. A. (2021) · Archives of Women s Mental Health · doi:10.1007/s00737-021-01111-w · Cited by 15
“Depression is a mental health condition that 17% of women are estimated to experience at some point in their lifetime (Shorey et al. 2018).”
Background
Increasing social support for women with postpartum depression through attribution theory guided vignettes and video messages: The understudied role of effort
Ruybal, A. L., & Siegel, J. T. (2021) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2021.104197 · Cited by 13
Intergenerational neuroimaging study: mother–infant functional connectivity similarity and the role of infant and maternal factors
Kim, P., Chen, H., Dufford, A. J., Tribble, R. C., Gilmore, J. H., & Gao, W. (2021) · Cerebral Cortex · doi:10.1093/cercor/bhab408 · Cited by 14
Mothers With Postpartum Psychiatric Disorders: Proposal for an Adapted Method to Assess Maternal Sensitivity in Interaction With the Child
Heinisch, C., Galeris, M.-G., Gabler, S., Simen, S., Junge‐Hoffmeister, J., Fößel, J. M., & Spangler, G. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00471 · Cited by 18
Impact of mHealth interventions during the perinatal period on maternal psychosocial outcomes: a systematic review protocol
Dol, J., Richardson, B., Murphy, G. T., Aston, M. L., McMillan, D., & Campbell-Yeo, M. L. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-d-19-00003 · Cited by 13
Prevalence of Postpartum Depression and Associated Predictors Among Taiwanese Women in a Mother-Child Friendly Hospital
Shao, H.-H., Lee, S.-C., Huang, J., & Hwang, L. (2021) · Asia Pacific Journal of Public Health · doi:10.1177/10105395211001172 · Cited by 13
Impact of COVID‐19 pandemic on postpartum depression among mothers of extreme and early preterm infants
Vatcheva, T., Mostaert, A., Ingelgem, V. V., Henrion, E., & Legros, L. (2021) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13859 · Cited by 13
Psychological dilemmas and distress among Chinese primiparas during the postpartum transition underlying implicit cultural norms: a phenomenological inquiry
Nan, Y., Yang, L., Nisar, A., Zhang, J., Gao, Y., Zhang, M., Liu, F., Li, X., & Zhang, Y. (2025) · BMC Psychology · doi:10.1186/s40359-025-03264-0 · Cited by 14
Poly- and perfluoroalkyl substances exposure during pregnancy and postpartum depression: Evidence from the Shanghai birth cohort
Wang, H., Ren, T., Zhang, N., Xia, W., Xiang, M., Ran, J., & Zhang, J. (2023) · Chemosphere · doi:10.1016/j.chemosphere.2023.137941 · Cited by 13
An exploration of masculinity, social support and depression in new and experienced fathers
Short, S., Davis, P. E., & Ndzi, E. G. (2023) · Midwifery · doi:10.1016/j.midw.2023.103715 · Cited by 17
Co-designing a nature-based intervention to promote postnatal mental health for mothers and their infants: a complex intervention development study in England
Hall, K., Evans, J., Roberts, R., Brown, R., Duggan, L., Williamson, M., Moran, P., Turner, K. M., & Barnes, C. R. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-075366 · Cited by 13
Detecting your depression with your smartphone? – An ethical analysis of epistemic injustice in passive self-tracking apps
Faissner, M., Kuhn, E. M., Müller, R., & Laacke, S. (2024) · Ethics and Information Technology · doi:10.1007/s10676-024-09765-7 · Cited by 15
“Since postpartum depressions are, with a prevalence of around 17%, very common among mothers and have a complex bio-psychosocial etiology (Shorey et al., 2018), the woman in Fricker’s example, is disadvantaged in understanding what she is going through.”
Caring for the mother-child dyad as a family physician.
Tsang, L., Ng, D. C. C., Chan, Y. H., & Chen, H. Y. (2019) · Singapore medical journal · doi:10.11622/smedj.2019128 · Cited by 14
Self-citation
Spontaneous and induced labor: association with maternal well-being three months after childbirth
Ponti, L., Ghinassi, S., & Tani, F. (2021) · Psychology Health & Medicine · doi:10.1080/13548506.2021.1956554 · Cited by 13
“Overall, research has mainly focused on postpartum depression (PPD) (Leach et al., 2017), a disorder that occurs in 8 to 26% of women during the postpartum period (Shorey et al., 2018).”
Method
The validation of the brief COPE in a belgian perinatal population
van Gils, Y., Bleijenbergh, R., Brosens, C., den Branden, L. V., Rimaux, S., & Kuipers, Y. (2022) · Maternal and Child Health Journal · doi:10.1007/s10995-022-03476-5 · Cited by 13
“…wellbeing throughout the perinatal period, with varying prevalence rates of depression and anxiety between 17 and 20% and 17–32% respectively (Razurel et al., 2011; Fontein-Kuipers et al., 2015, 2016; Dennis et al., 2017; Nakić Radoš et al., 2018; Shorey et al., 2018; Kuipers et al., 2019).”
Background
Prevalence, Incidence, and Persistence of Postpartum Anxiety, Depression, and Comorbidity
Lauzurique, M. E., Fernández, Y. V., Dennis, C., Quesada, M. R., Valdés, G. Á., Lye, S. J., & Tamayo-Pérez, V. (2022) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0000000000000662 · Cited by 12
“The EPDS is a 10-item self-report instrument specifically designed to assess postpartum depression symptoms(23) and is the most frequently used tool to identify at-risk women.(24) Using a cut-off point of more than 12 at 6 weeks postpartum, the EPDS has a sensitivity of 67% to 81% and a specificity ranging from 89% to…”
BackgroundMethodInfluential
The relationship between body dissatisfaction and postpartum depressive symptoms: A cross-sectional study
Chen, M., & Chang, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.102 · Cited by 12
Biopsychosocial Models of Peripartum Depression: A Narrative Review
Žutić, M. (2023) · Clínica y Salud · doi:10.5093/clysa2023a16 · Cited by 15
Maternal and Infant Performance on the Face-to-Face Still-Face Task following Maternal Cognitive Behavioral Therapy for Postpartum Depression
Ntow, K. O.-B., Krzeczkowski, J. E., Amani, B., Savoy, C. D., Schmidt, L. A., & Lieshout, R. J. V. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.101 · Cited by 12
Postpartum depression and mother–offspring conflict over maternal investment
Gunst, A., Sundén, M., Korja, R., Boddy, A. M., Kotler, J., Paavonen, E. J., Uusitupa, H., Karlsson, L., Karlsson, H., & Antfolk, J. (2020) · Evolution Medicine and Public Health · doi:10.1093/emph/eoaa049 · Cited by 12
Gestational Folic Acid Administration Alleviated Maternal Postpartum Emotional and Cognitive Dysfunction in Mice
Zhang, Q., Huang, Q., Li, Y., Liu, W., Ruan, J., Nong, Y., Chen, Y., Fan, L., Wei, J., Wang, S., et al. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.701009 · Cited by 12
The Parenthood Penalty in Mental Health: Evidence from Austria and DenmarkPreprint
Ahammer, A., Glogowsky, U., Halla, M., & Hener, T. (2023) · Social Science Research Network · doi:10.2139/ssrn.4580836 · Cited by 19
Examining the Relationship Between Black Racial Identity Clusters and Postpartum Depressive Symptoms
James, K. F., Aycock, D. M., Barkin, J. L., & Hires, K. A. (2021) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903211002650 · Cited by 11
“Globally, 12% of mothers experience postpartum depression (PPD; Shorey et al., 2018).”
Background
Early‐life exposure to selective serotonin reuptake inhibitors: Long‐term effects on pain and affective comorbidities
Baudat, M., de Kort, A. R., van den Hove, D., & Joosten, E. A. J. (2021) · European Journal of Neuroscience · doi:10.1111/ejn.15544 · Cited by 12
“SERT is responsible for the reuptake of extracellular serotonin and is the main target of selective serotonin reuptake inhibitors (SSRI); 16.4% and 12% of pregnant women suffer from ante-partum and/or post-partum depression, respectively (Okagbue et al., 2019; Shorey et al., 2018).”
BackgroundInfluential
Maternal expectations of fetal gender and risk of postpartum depression
Rong, X.-F., Li, M., Pérez-López, F. R., Wu, J., & Zhang, B. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05419-6 · Cited by 14
“The disorder is characterized by persistent low emotion in the puerperium and may impact the mother’s quality of life and family functioning, resulting in consequences for offspring development and mental health [3, 4].”
Background
Association between adverse childhood experiences and perinatal depressive symptoms: a cross-sectional analysis of 16,831 women in Iceland
Bränn, E., Vaina, A., Daníelsdóttir, H. B., Thordardottir, E. B., Yang, Q., Jakobsdóttir, J., Aspelund, T., Hauksdóttir, A., Valdimarsdóttir, U. A., & Lu, D. (2023) · Archives of Women s Mental Health · doi:10.1007/s00737-023-01369-2 · Cited by 11
“(Shorey et al. 2018; Woody et al. 2017).”
Perception of care and emotional impact of perinatal women during COVID-19: A multicenter study
Molas-Tuneu, M., Briones‐Buixassa, L., Díaz, L. G., Perez-Meana, H. M., Berrocoso, S., Naudó-Molist, J., Escribà-Salvans, A., Antentas, M., Barbero-Jambrina, S., & Lladó‐Jordan, G. (2024) · Journal Of Advanced Pharmacy Education And Research · doi:10.51847/aqbgfnhjf3 · Cited by 11
The mediating effect of family support in the relationship between socio-economic status and postpartum depressive symptoms
Xiao, Y., Cui, Y., Li, F., Zeng, W., Rozelle, S., Shi, C., Xu, J., Shi, J., Li, G., & Jiang, F. (2024) · BMC Public Health · doi:10.1186/s12889-024-20849-3 · Cited by 11
A longitudinal study of the subjective birth experience and the relationship to mental health
Märthesheimer, S., Hagenbeck, C., Helbig, M., Balan, P., Fehm, T. N., & Schaal, N. K. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07348-y · Cited by 14
“The incidence rate of postpartum depression among healthy women is about 17% [31].”

Authors: Shorey, S., Chee, C. Y. I., Ng, E. D., Chan, Y. H., Tam, W. W. S., & Chong, Y. S.
Affiliations: National University of Singapore (SG)
National University Hospital (SG)
Corresponding author: Shorey, Shefaly
ORCID: Shorey, Shefaly
Chee, Cornelia Yin Ing
Ng, Esperanza Debby
Chan, Yiong Huak
Tam, Wilson Wai San
Chong, Yap Seng
Venue: Journal of Psychiatric Research
Publisher: Elsevier BV
Published: 2018-09
Volume: 104
Pages: 235-248
ISSN: 0022-3956 (ISSN-L)
DOI: 10.1016/j.jpsychires.2018.08.001
OpenAlex: W2885511794
Cited by: 1,055
References: 106
Citations by year: 2026: 127 · 2025: 160 · 2024: 181 · 2023: 175 · 2022: 166 · 2021: 136 · 2020: 76 · 2019: 28 · 2018: 4
FWCI: 11.06
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Psychiatric Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: postpartum depression, prevalence, incidence, term infants, postpartum screening, diagnostic tools, regional variation, postpartum period
MeSH terms: Female, Humans, Mothers, Incidence, Prevalence, Databases, Factual, Depression, Postpartum

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Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis

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