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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Malekmohammadi, N., Torkian, S., Rohina, Z., & Shahesmaeili, A. (2022) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-108747 · Cited by 5
“The prevalence varies from 8% in Europe to 26% in Middle East (10).”
Background
The Role of Early Maladaptive Schemas in Postpartum Depression
ÖZTURAN, D. D., Gülücü, S., & Özsoy, F. (2023) · Perspectives In Psychiatric Care · doi:10.1155/2023/6163959 · Cited by 5
Reproductive Experiences and Cardiovascular Disease Care in Pregnancy Capable and Post-Menopausal Individuals: Insights from the American Heart Association Research Goes Red Registry
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The Association Between Maternal Depressive Symptoms and Toddlers’ Developmental and Behavioral Problems: A Population-Based Study
Wu, P., de Banate, M. A., Kim, H., Viner-Brown, S. I., & High, P. C. (2023) · Clinical Pediatrics · doi:10.1177/00099228231179672 · Cited by 6
“26 In this meta-analysis, maternal depression prevalence was highest at 1 year postpartum (25%), closely followed by 7 to 12 months postpartum (20%), 4 to 6 months postpartum (16%), then 0 to 3 months (14%).”
BackgroundInfluential
Depressive symptoms in mothers of preterm infants before and during COVID‐19 restrictions in neonatal intensive care units
Itoshima, R., Tuura, K., Toome, L., Varendi, H., Saik, P., Axelin, A., Lehtonen, L., & Ahlqvist‐Björkroth, S. (2023) · Acta Paediatrica · doi:10.1111/apa.16886 · Cited by 5
Emotional and relational protective factors during pregnancy and psychological well-being and personal growth after childbirth
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“The most dominant risk factor is region, with women from West Asia, Australia, and the Middle East having a higher prevalence of mental distress (Heyne et al., 2022; Shorey et al., 2018).”
Influential
Association between epidural analgesia and postpartum psychiatric disorders: A meta-analysis
Ghanbari-Homaie, S., Jenani, S.-P., Faraji-Gavgani, L., Hosenzadeh, P., & Rezaei, M. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e27717 · Cited by 6
“Studies have shown that postpartum depression affects a significant portion of the global population, with reported rates ranging from 8% to 26% [4,5].”
Background
Family and facility care variables attributing to postnatal depression among women in two tribal-dominated districts of Odisha: Log model analysis to suggest intervention
Kar, S., Samantaray, P. C., Patnaik, L., Mishra, A., & Lakshmi, P. (2024) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1367_23 · Cited by 5
Prevalence of postpartum depression and its relationship with birth experience among adolescent mothers: a cross-sectional study
Ghanbari‐Homayi, S., Naseri, E., Mirghafourvand‬‬‬‬‬‬‬‬‬‬‬‬‬‬, M., & Vahidi, F. (2024) · Payesh (Health Monitor) Journal · doi:10.61186/payesh.23.2.199 · Cited by 5
Time trends in incidence of postpartum depression and depression in women of reproductive age
Egsgaard, S., Bliddal, M., Rasmussen, L., Mægbæk, M. L., Liu, X., & Munk‐Olsen, T. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.167 · Cited by 9
Post-earthquake spiritual well-being and depression levels of postpartum women in Turkey
Akça, E. İ., & Öztaş, H. G. (2024) · Psychology Health & Medicine · doi:10.1080/13548506.2024.2430859 · Cited by 5
“In a systematic review and meta-analysis study, the prevalence of postpartum depression among healthy mothers without a history of depression was reported as 17% (Shorey et al., 2018).”
The prevalence of postpartum depression among women with physical disabilities: a systematic review and meta-analysis
Pingeton, B. C., Evohr, B., & Goodman, S. H. (2025) · Archives of Women s Mental Health · doi:10.1007/s00737-025-01558-1 · Cited by 5
Depression and stress in Korean parents: A cohort study
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Postpartum Depression
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The Effects of the Solution-Focused Model on Anxiety and Postpartum Depression in Nulliparous Pregnant Women
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Time of Change: Health Effects of MotherhoodPreprint
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Prevalence and Risk Factors of Postpartum Depression in Palestinian Women in the Hebron Governorate, Palestine
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Comparison of the prevalence of probably postpartum depression before and during the covid-19 pandemic in Turkey: a systematic review and meta-analysis
Karaçam, Z., Ekin, P., & ŞARALDI, H. B. (2025) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-025-02905-4 · Cited by 4
“PPD is usually characterized by temporary mood swings, sleep - lessness, disorganized behavior, nervousness and agitation [10].”
Influential
Maternal Mental Health and Child Dietary Diversity in Rural Kenya: Findings From a Pooled Analysis of 2 Baseline Studies
Kalam, M. A., McCann, J. K., Shakil, Z., Gambari, A., Ochieng, M., & Jeong, J. (2025) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2025.107497 · Cited by 5
“A recent meta-analysis conducted across 46 countries estimated the global pooled prevalence of maternal depression at ~20% [4] with a higher burden at 24.7% in lower-and-middle-income countries (LMICs) than that in high-income countries (HICs) [5,6].”
Influential
Levers of care in the health system: A qualitative study of experiences with perinatal mental health screening, referrals, and treatment among birthing people of color in California
Sudhinaraset, M., Woofter, R. C., Ebuehi, E.-P., Richards, M., Tobin, C. S. T., & Rao, R. (2025) · SSM - Qualitative Research in Health · doi:10.1016/j.ssmqr.2025.100610 · Cited by 4
Maternal mental health: A longitudinal study of depression and anxiety across pregnancy and postpartum
Linde, K., Treml, J., Lehnig, F., Nagl, M., Stepan, H., & Kersting, A. (2025) · Midwifery · doi:10.1016/j.midw.2025.104571 · Cited by 9
Labor Epidural Anesthesia and Postpartum Depression Risk: Prospective Observation Study and Mendelian Randomization Analysis
Zheng, W., Gan, P., Wan, X., Wang, X., Gong, J., & Min, J. (2025) · Drug Design, Development and Therapy · doi:10.2147/dddt.s533306 · Cited by 4
Do sex and gender matter in the pharmacological treatment of depression?
Seifert, J. (2025) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-025-04611-z · Cited by 3
“A recent meta-analysis suggests that the prevalence of postpartum depression in otherwise healthy mothers (i. e., without a prior history of depression) is approximately 17% (Shorey et al. 2018).”
The global prevalence of major depressive disorder during the peripartum period: a systematic review and meta-regression
Ferrari, A. J., Miller, P. A., Shadid, J., Herrera, A. M. M., Ahmed, S. M., Malpani, P., Noyes, T. S., Chihara, I., McHugh, T. A., Nanditha, N. G. A., et al. (2026) · The Lancet Psychiatry · doi:10.1016/s2215-0366(26)00085-4 · Cited by 4
The economic evaluation of an Internet-based parental wellbeing intervention
Lee, P., Sanders, D., Milgrom, J., Kavanagh, D. J., & Scuffham, P. (2022) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x221137113 · Cited by 4
Factors associated with maternal depressive symptoms up to 25 years after childbirth: A longitudinal prospective cohort study
Agnafors, S., Sydsjö, G., Widegren, W., & Bladh, M. K. (2023) · Mental Health Science · doi:10.1002/mhs2.31 · Cited by 4
Dynamics of postnatal depressive symptoms in early parenthood
Skjerdingstad, N., Speyer, L. G., Isvoranu, A., Moe, V., & Fredriksen, E. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05934-6 · Cited by 4
The maternal six week postnatal check
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Postpartum Depression and Physical Activity Among Women Attending Postnatal Clinics in a Tertiary Hospital in Nigeria
Georgiana, N. N. (2021) · Journal of Research and Health · doi:10.32598/jrh.11.5.1915.1 · Cited by 5
The Mother–Offspring Conflict: The Association Between Maternal Sleep, Postpartum Depression, and Interbirth Interval Length
Gunst, A., Sjöström, E., Sundén, M., & Antfolk, J. (2021) · Evolutionary Psychology · doi:10.1177/14747049211046162 · Cited by 4
Effectiveness of aromatherapy for intrapartum and postpartum emotional problems among parturient women: A meta‐analysis of randomized controlled trials
Hu, T., Lee, S., & Loh, E. (2022) · Japan Journal of Nursing Science · doi:10.1111/jjns.12471 · Cited by 4
Birth, Postpartum, and Home Experiences of Individuals With Lower Extremity Nerve Injury
Sleutel, M. R., Newcomb, P., Valdez, E., Coates, D., & Urban, R. W. (2022) · Nursing for Women s Health · doi:10.1016/j.nwh.2022.03.009 · Cited by 4
Investigating the Efficacy of an 18-Week Postpartum Rehabilitation and Physical Development Intervention on Occupational Physical Performance and Musculoskeletal Health in UK Servicewomen: Protocol for an Independent Group Study Design
Elliott-Sale, K. J., Bostock, E. L., Jackson, T., Wardle, S. L., O’Leary, T. J., Greeves, J. P., & Sale, C. (2022) · JMIR Research Protocols · doi:10.2196/32315 · Cited by 4
“Postpartum depression is common in the months after childbirth [20-22]; a m-analysis of 58 studies reported a prevalence of 17% in mothers [20].”
Background
Transition to Fatherhood
Molloy, S., Cole, B. P., Dye, A. R., Singley, D. B., & Ingram, P. B. (2022) · Springer eBooks · doi:10.1007/978-3-031-14498-1_5 · Cited by 4
Effectiveness of non-pharmacological treatments for postpartum depression: an umbrella review protocol
Lu, X., Yang, Z., Liu, F., Zhou, Y., Xu, Y.-Q., Zhuo, Y., Huang, X., & Gong, M. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-066395 · Cited by 4
Self-criticism and self-compassion as mediators of the relationship between alexithymia and postpartum depressive symptoms
Andrei, A., Webb, R., & Enea, V. (2023) · Psihologija · doi:10.2298/psi220422002a · Cited by 4
European health professionals’ knowledge, attitudes and beliefs about perinatal depression and body image concerns
Yager, Z., Calleja‐Agius, J., Jagomägi, T., Khalaf, A., Sjöbeck, J., Karamouzi, P., Holeva, V., Runnel, R., Iozsa, D.-A., & Persson, M. (2023) · Advances in Mental Health · doi:10.1080/18387357.2023.2210703 · Cited by 4
“Gestational weight gain [GWG], and perinatal anxiety and depression [PND] are recognised as being two of the largest and most complex challenges in pregnancy and postpartum care (Shorey et al., 2018).”
Background
Postpartum Depression: An Overview of Reviews and Guide for Management
Rai, B., Dagar, N., Chauhan, D., & Grover, S. (2023) · Journal of Mental Health and Human Behaviour · doi:10.4103/jmhhb.jmhhb_254_22 · Cited by 4
Breaking boundaries: A chronology with future directions of women in exercise physiology research, centred on pregnancy
Corson, A. E., Macdonald, M. L., Tzaneva, V., Edwards, C. M., & Adamo, K. B. (2024) · Advanced Exercise and Health Science · doi:10.1016/j.aehs.2024.04.001 · Cited by 5
“Prenatal depression is a strong predictor of postpartum depression 71 , a condition impacting approximately 17% of gesPs globally 72 .”
Background
Investigation and Analysis of Emotional State and Oxytocin Level in Patients with Postpartum Depression
Yu, X., Zhang, W., & Gao, Y. (2024) · Actas Españolas de Psiquiatría · doi:10.62641/aep.v52i3.1627 · Cited by 5
“The survey data have shown that the probability of PPD is getting higher and higher in postpartum women, and the incidence has reached 15%–30% [21].”
Background
The effect of telecounseling on depression in primiparous mothers during the postpartum period: A randomized controlled trial
Koç, E., BALTACI, N., & Bal, S. (2024) · Nursing and Health Sciences · doi:10.1111/nhs.13136 · Cited by 4
Can postpartum depression be prevented with care provided to primiparae using Levine's Conservation Model?: A single-blind randomized controlled trial
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“During the postpartum period, women are twice as likely to become depressed compared to other periods of their lives (Shorey et al., 2018 ).”
Influential
Impact of Paternal Postpartum Depression on Maternal and Infant Health: A Narrative Review of the Literature
Mahmoud, H. A. H., Lakkimsetti, M., Alverde, M. J. B., Shukla, P. S., Nazeer, A. T., Shah, S., Chougule, Y., Nimawat, A., & Pradhan, S. (2024) · Cureus · doi:10.7759/cureus.66478 · Cited by 7
“A recent meta-analysis showed that 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) [5].”
BackgroundMethodInfluential
Incidence and Predictors of Postpartum Depression Diagnoses among Active-Duty U.S. Army Soldiers
Wu, S., Kaplan, J., Trautwein, M. L., Nelson, D. A., Duong, A., Woolaway-Bickel, K., Shaw, J. G., Shaw, K. A., & Kurina, L. M. (2024) · Journal of Women s Health · doi:10.1089/jwh.2023.1010 · Cited by 4
“32 It is possible that some variability in these associations could exist across different types of populations.”
Efficacy of Nurse-led Telepsychological Intervention for Patients with Postpartum Depression: A Systematic Review and Meta-analysis
Luo, T., Zhang, Z., Li, J., Li, Y., Xiao, W., Zhou, Y., Jing, Q., & Zhao, L. (2024) · ALPHA PSYCHIATRY · doi:10.5152/alphapsychiatry.2024.231492 · Cited by 5
Strength Amidst Struggles: A Descriptive Qualitative Study of Maternal Experiences of Low Socioeconomic Status Mothers in the Third Month Postpartum
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Self-citation
The Effect of Early‐Initiated Half‐Swaddling and Kangaroo Care Practices on Maternal Sleep Quality and Postpartum Depression in Term Infants: A Randomized Controlled Trial
Küçükkaya, B., Öztürk, T. C., Erginler, G., Temiz, M., & Erçel, Ö. (2025) · Nursing and Health Sciences · doi:10.1111/nhs.70066 · Cited by 4
“Systematic reviews report that the global prevalence of PPD is between 14% and 18% (Liu et al. 2022; Shorey et al. 2018).”
Identifying risk factors for postpartum depression in Mashhad, Iran, 2017–2024: a population-based case-control study
Moradi, A., Norouzi, M., & Farkhani, E. M. (2025) · Archives of Public Health · doi:10.1186/s13690-025-01544-0 · Cited by 7

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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