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Cited by 16Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

Epidemiology, pathophysiology, and interventions for postpartum depression: Systematic review

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Ji, Qing-Qing, Wang, Meng-Yi·2025·World Journal of Clinical Cases
DOI 10.12998/wjcc.v13.i29.110948PMC PMC12417937
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Abstract

BACKGROUND Postpartum depression (PPD) is a prevalent and debilitating psychiatric disorder affecting maternal mental health, infant development, and family well-being. Despite increasing global awareness, significant disparities remain in screening, diagnosis, and treatment, particularly in low-resource and culturally diverse settings. The complex interplay of biological and psychosocial determinants complicates conventional intervention models. Integrating epidemiological patterns, pathophysiological mechanisms, and sociocultural factors will inform more effective and equitable strategies for PPD screening, prevention, and treatment. AIM To synthesize current evidence on risk factors, underlying mechanisms, and interventions for postpartum depression and outline directions toward equitable care. METHODS A narrative review was conducted following PRISMA 2020 guidelines. Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed, Web of Science, EMBASE, and PsycINFO. Inclusion criteria comprised studies addressing PPD epidemiology, risk stratification, biological mechanisms, and intervention strategies. After screening and full-text review, 84 studies were included. Study designs primarily involved cohort studies, randomized controlled trials, and meta-analyses. Extracted data were categorized thematically and assessed for methodological quality and generalizability. RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation, neurochemical changes, psychosocial stressors, and cultural influences. Primary risk factors include personal or family history of depression, antenatal anxiety, low maternal self-efficacy, and inadequate social support. Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening, cognitive behavioral therapy, interpersonal psychotherapy, psychoeducation, and pharmacological treatments such as brexanolone and zuranolone. Culturally adapted, community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability, particularly in underserved populations. Emerging evidence highlights inflammatory biomarkers (e.g. , interleukin-6 and C-reactive protein), AI-assisted screening tools, and family-inclusive strategies as promising for enhanced detection and outcomes. CONCLUSION Effective PPD management requires integrative, culturally sensitive approaches, prioritizing scalable, personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.

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  • Several 2025 studies highlight continuing gaps in access to trained mental-health professionals, even in high-income countries.

    “Furthermore, several 2025 studies highlight continuing gaps in access to trained mental-health professionals, even in high-income countries, underscoring the need for locally adapted models that bridge clinical and community care [51].”

    From Understanding mothers’ lived experiences of postpartum depression: a qualitative phenomenological study (2025) · cites this paper as [51]

    The Results section on sociocultural disparities identifies scarce professional mental-health services and barriers to care, especially in low- and middle-income countries. The intervention-strategies section also discusses gaps where specialist care is scarce. The cited review does not establish the claimed gaps in high-income countries or attribute that finding to several 2025 studies. (LLM, conf=0.85)

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  • Recent cross-cultural findings link low perceived social support and role-expectation strain with worsened postpartum-depression outcomes.

    “Finally, recent cross-cultural findings link low perceived social support and role-expectation strain with worsened postpartum-depression outcomes, reinforcing our results and offering a nuanced understanding that can inform future international collaboration and culturally sensitive program design [49–51].”

    From Understanding mothers’ lived experiences of postpartum depression: a qualitative phenomenological study (2025) · cites this paper as [51]

    The Results section on biological, psychological, and sociocultural determinants links inadequate partner support and social isolation to elevated postpartum-depression risk. The section on sociocultural disparities says familial role expectations contribute to symptom concealment and delayed help-seeking, but does not directly link those expectations to worsened depression outcomes or specifically assess perceived social support. (LLM, conf=0.82)

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Authors
Ji, Q.-Q., & Wang, M.-Y.
Affiliations
Sichuan University (CN)
Venue
World Journal of Clinical Cases
Publisher
Baishideng Publishing Group Inc.
Published
2025-10-16
Volume
13
Issue
29
Pages
110948-110948
ISSN
2307-8960 (ISSN-L)
DOI
10.12998/wjcc.v13.i29.110948
PMC
PMC12417937
OpenAlex
W4413800111
Cited by
16
References
12
Citations by year
2026: 14 · 2025: 2
FWCI
2.63
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • World Journal of Clinical Cases (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc)
Funders
National Natural Science Foundation of China (81772266)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
postpartum depression, maternal mental health, risk factors, pathophysiology, hormonal dysregulation, neurochemical changes, psychosocial stressors, cultural influence, screening, cognitive behavioral therapy, interpersonal psychotherapy, brexanolone, zuranolone, stepped care, task shifting, community-based care, inflammatory markers, artificial intelligence screening, health equity, resource-limited settings

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