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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Background
Patient reported pregnancy and birth outcomes in genetic neuromuscular diseases
Moore, U., Emmons, S., Rufibach, L., Straub, V. W., Díaz‐Manera, J., & Guglieri, M. (2022) · Neuromuscular Disorders · doi:10.1016/j.nmd.2022.12.013 · Cited by 8
A dynamic perspective on depressive symptoms during the first year postpartum.
Winstone, L. K., Somers, J. A., Curci, S. G., & Luecken, L. J. (2023) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000878 · Cited by 8
Personal resources associated with peripartum depression among mothers of NICU hospitalised preterm infants
Kestler‐Peleg, M., & Lavenda, O. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1873336 · Cited by 9
“Over the recent decades, growing attention has been paid in the Western World to maternal PPD, which is prevalent among 8%–26% of the population of women who give birth (Gelaye et al., 2016; Shorey et al., 2018).”
Background
Who decides to follow the referral advice after a positive postpartum depression screening result? Reflections about the role of sociodemographic, health, and psychological factors from psychological consultations – a cross-sectional study
Chrzan-Dętkoś, M., Murawska, N., & Łockiewicz, M. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.10.068 · Cited by 8
Risk Factors, Prognosis, Influence on the Offspring, and Genetic Architecture of Perinatal Depression Classified Based on the Depressive Symptom Trajectory
Ohseto, H., Takahashi, I., Narita, A., Obara, T., Ishikuro, M., Kobayashi, N., Kikuchi, S., Li, X., Noda, A., Murakami, K., et al. (2024) · Depression and Anxiety · doi:10.1155/2024/6622666 · Cited by 7
“Perinatal depression (PD) is characterized by depressive symptoms emerging during pregnancy or postpartum [1], a ﬀ ecting approximately 15% – 20% of women [2, 3], resulting in poor family relationships [4], poor infant care [5], and suicidal ideation [6].”
Background
Ignored sufferers: a phenomenological inquiry into the lived experiences of postpartum depression among men
Malik, A. (2024) · Advances in Mental Health · doi:10.1080/18387357.2024.2345236 · Cited by 7
“This finding is consistent with previous research that has highlighted communication and support within relationships as protective against PPD (Shorey et al., 2018).”
Oxytocin and women’s health in midlife
Dunietz, G. L., Tittle, L. J., Mumford, S. L., O'Brien, L. M., Baylín, A., Schisterman, E. F., Chervin, R. D., & Young, L. J. (2024) · Journal of Endocrinology · doi:10.1530/joe-23-0396 · Cited by 7
Universal screening of postpartum depression with Edinburgh Postpartum Depression Scale: A prospective observational study
Fijean, A., Marçais, M., Banasiak, C., Morel, O., Dahlhoff, S., Oliéric, M.-F., Mottet, N., Epstein, J., & Bertholdt, C. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15722 · Cited by 7
“14,15 However, the prevalence is not comparable because many studies included in trhe meta-analysis were based on screening tools and not psychiatric interviews.”
The prevalence of depression in women with pregnancy‐related pelvic girdle pain: A systematic review and meta‐analysis
Halliday, B., Chatfield, S., Hosking, J., & Freeman, J. A. (2024) · Health Science Reports · doi:10.1002/hsr2.2308 · Cited by 12
Holistic Analysis and Development of a Pregnancy Risk Detection Framework: Unveiling Predictive Insights Beyond Random Forest
Irfan, N., Zafar, S., & Hussain, I. (2024) · SN Computer Science · doi:10.1007/s42979-024-03409-9 · Cited by 7
Trends in the prevalence of antenatal and postnatal depression in Bangladesh: A systematic review and meta-analysis
Hoq, M. I., Hossain, M. M., Sayeed, M. A., & Jakaria, M. (2025) · Heliyon · doi:10.1016/j.heliyon.2025.e41955 · Cited by 10
Traumatic Childbirth Experiences and their Association with Postpartum Psychiatric Disorders: A Systematic Review
Baldini, V., Gnazzo, M., Ronchi, D. D., Carotenuto, M., Pera, M. C., & Fiorillo, A. (2025) · Psychiatric Quarterly · doi:10.1007/s11126-025-10180-4 · Cited by 9
“Furthermore, past negative experiences, including childhood trauma or mental health issues, may increase the risk of perceiving childbirth as traumatic and developing subsequent psychopathology [15].”
Development and validation of an interpretable machine learning model and online web-based calculator based on social-ecosystem theory for early prediction of postpartum depression: a longitudinal study
Lin, S., Wang, P., Yue, C., Kuang, G., Han, X., Zhang, Y., Wang, X., Wang, M., Huan, S., Zhang, X., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1685305 · Cited by 7
“The detection rate of PPD in this study was 34%, which was consistent with the incidence reported in a meta-analysis study (27).”
Women’s Suicide in the First-Year Postpartum: A Population-based Study
Chen, Y., Canetto, S. S., Wu, K. C., & Chen, Y. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114594 · Cited by 7
Associations between maternal postpartum depression and infant temperament in treatment-seeking mothers prior to and during the COVID-19 pandemic
Chang, O., Huh, K., Savoy, C. D., Krzeczkowski, J. E., & Lieshout, R. J. V. (2023) · Development and Psychopathology · doi:10.1017/s0954579422001353 · Cited by 9
“Postpartum depression (PPD) affects up to one in five mothers in the first year after delivery (Shorey et al., 2018) and has been linked to an increased risk of future depressive episodes (Turkcapar et al., 2015), partner relationship problems (Odinka et al., 2018), and cognitive, social,…”
Background
The impact of prepartum pandemic-related perceived stress on anxiety symptoms in the postpartum: The role of perceived childbirth experiences
Spinoni, M., Solorzano, C. S., & Grano, C. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102762 · Cited by 8
Association between the use of epidural analgesia during labour and incidence of postpartum depression
Ahmad, H. M. Y., Althagafi, L. A., Albluwe, G. Z., Kadi, S. M., Alhassani, R. I., & Bahkali, N. M. (2023) · PLOS ONE · doi:10.1371/journal.pone.0289595 · Cited by 7
Effectiveness of the third wave cognitive behavior therapy for peripartum depression treatment–A systematic review
Muñoz, M. D. L. F. R., Radoš, S. N., Uka, A., Marques, M., Maia, B., Matos, M., Branquinho, M., Aydın, R., Mahmoodi, V., Chrzan‐Dętkoś, M., et al. (2023) · Midwifery · doi:10.1016/j.midw.2023.103865 · Cited by 9
Association of parental depression with adolescent children’s psychological well-being and health behaviors
Kim, S.-I., Kim, S. M., Park, S. J., Song, J., Lee, J., Kim, K. H., & Park, S. M. (2024) · BMC Public Health · doi:10.1186/s12889-024-18337-9 · Cited by 7
“Considering that East Asia exhibited the highest rates of parental depression compared that Europe showed the lowest rates [19], it becomes essential to explore how parental depression affects adolescnet children in Asian contries with reflecting the cultural context in Asia.”
Background
Association between neonatal homecare for preterm infants and incidence of severe postpartum depression in mothers
Andersen, K. S. H., Holm, K. G., Nordentoft, M., & Hjorthøj, C. R. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.110 · Cited by 7
Mental health of Urban Mothers (MUM) study: a multicentre randomised controlled trial, study protocol
Schwank, S. E., Chung, H.-F., Hsu, M., Fu, S.-C., Du, L., Zhu, L., Huang, H.-Y., Andersson, E. P., & Acharya, G. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-041133 · Cited by 8
Postpartum Depression Among Women With Disabilities: A Multicultural Counseling Perspective
Öksüz, E. E. (2021) · Journal of Multicultural Counseling and Development · doi:10.1002/jmcd.12205 · Cited by 8
Treatment Preferences for Postpartum Depression Among New Israeli Mothers: The Contribution of Health Beliefs and Social Support
Simhi, M., Cwikel, J., & Sarid, O. (2021) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903211042084 · Cited by 7
“The prevalence of postpartum depression (PPD) among the general population of new mothers in Western countries is estimated at 9% to 17% (Shorey et al., 2018; Yelland et al., 2010).”
Background
Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study
Haßdenteufel, K., Lingenfelder, K., Schwarze, C. E., Feißt, M., Brusniak, K., Matthies, L. M., Goetz, M., Wallwiener, M., & Wallwiener, S. (2021) · JMIR Mental Health · doi:10.2196/26665 · Cited by 8
“These findings are in line with the results of a review published in 2018, in which an increase in depressive symptoms 6 months postpartum was reported and may reflect the added stress due to caring for a newborn and the constant demands of the infant [85].”
Result
Applying Rasch methodology to examine and enhance precision of the Edinburgh Postnatal Depression Scale
Barber, C. C., Middlemiss, W., & Medvedev, O. N. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.009 · Cited by 7
Postpartum Mood and Anxiety Disorders: A Lexicon of Metaphors
Beck, C. T. (2022) · Journal of Holistic Nursing · doi:10.1177/08980101221097212 · Cited by 8
The Association Between Postpartum Insurance Instability and Access to Postpartum Mental Health Services: Evidence From Colorado
Eliason, E. L., & Gordon, S. H. (2022) · Women s Health Issues · doi:10.1016/j.whi.2022.06.010 · Cited by 7
Effectiveness of acupuncture in postpartum depression: A protocol for an overview of systematic reviews
Bu, F., Zhao, Y., Chai, J., Bing, B., & Wang, W. (2022) · Medicine · doi:10.1097/md.0000000000028678 · Cited by 7
“The prevalence of PPD in new mothers is as high as 16%,[2] and the recurrence rate of PPD in the second pregnancy reaches 30%.[3,4] PPD is characterized by depressed mood, loss of interest, sleep disturbances, psychomotor agitation or retardation, feelings of worthlessness, and even suicidal thoughts and behaviors in…”
Background
The Association between Perpetuation of Intimate Partner Violence and Family Support on Couples with an Incarcerated Partner
Tadros, E., & Tate, S. D. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912165 · Cited by 7
“[29] next explored men with a criminal history of IPV.”
Background
The transition to parenthood, opportunity to drink, drinking, and alcohol use disorder
Axinn, W. G., Banchoff, E., Cole, F., Ghimire, D. J., & Smoller, J. W. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109697 · Cited by 7
Neural Activation to Infant Cry Among Latina and Non-Latina White Mothers
Aran, Ö., Phu, T., Erhart, A., Watamura, S. E., & Kim, P. (2022) · Behavioural Brain Research · doi:10.1016/j.bbr.2023.114298 · Cited by 7
Increased depressive-like behaviour of postpartum Flinders sensitive and resistant line rats is reversed by a predictable postpartum stressor
Roets, M., Brand, L., & Steyn, S. F. (2023) · Behavioural Brain Research · doi:10.1016/j.bbr.2023.114321 · Cited by 8
Postpartum Depression in India: Perceptions by Key Stakeholders
Szajna, A., Tekkalaki, B. V., Nandagaon, V., Sogalad, M., Udapi, G., Raddi, S., & Kelly, P. J. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2186701 · Cited by 7
“The global prevalence of PPD is estimated to be 17% with low and middle-income countries (LMICs) reporting a higher prevalence than high-income countries (Shorey et al., 2018).”
Background
An economic evaluation of targeted case-finding strategies for identifying postnatal depression: A model-based analysis comparing common case-finding instruments
Camacho, E. M., Shields, G., Eisner, E., Littlewood, E., Watson, K., Chew-Graham, C. A., McMillan, D., Ali, S., & Gilbody, S. M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.04.106 · Cited by 7
Effects of maternal and paternal postnatal depressive symptoms on infants’ parasympathetic regulation in low‐income, Mexican American families
Lin, B., Yeo, A. J., Luecken, L. J., & Roubinov, D. S. (2020) · Developmental Psychobiology · doi:10.1002/dev.22073 · Cited by 8
“, 2010), with approximately 17% of mothers (Shorey et al., 2018) and 10.”
BackgroundInfluential
Optimism as a mediator of the association between social support and peripartum depression among mothers of neonatal intensive care unit hospitalized preterm infants
Kestler‐Peleg, M., & Lavenda, O. (2021) · Stress and Health · doi:10.1002/smi.3033 · Cited by 8
DOĞUM SONU DEPRESYONUN KİŞİLİK ÖZELLİKLERİ İLE İLİŞKİSİ
Sunay, Z., OKYAY, E. K., Gökbulut, N., & Uçar, T. (2021) · İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi · doi:10.33715/inonusaglik.813014 · Cited by 7
Predicting Mothers with Postpartum Depression using Machine Learning Approaches
Prabhashwaree, T. H. K. R., & Wagarachchi, N. M. (2022) · International Research Conference on Smart Computing and Systems Engineering (SCSE) · doi:10.1109/scse56529.2022.9905186 · Cited by 7
“Having a newborn is stressful enough:” Mothers’ experiences during the 2022 Infant Formula Shortage in Washington D.C.Preprint
Sylvetsky, A. C., Hughes, S., Moore, H. R., Murphy, J., Kuttamperoor, J. T., Sacheck, J. M., & Smith, E. R. (2022) · medRxiv · doi:10.1101/2022.07.31.22278224 · Cited by 7
Perinatal depression
Kroh, S. J., & Lim, G. (2021) · International Anesthesiology Clinics · doi:10.1097/aia.0000000000000325 · Cited by 6
Development and validation of the Peripartum depression scale
Radoš, S. N., Matijaš, M., Brekalo, M., & Žutić, M. (2024) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2024.100820 · Cited by 6

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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