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Cited by 18Maternal Mental Health During Pregnancy and PostpartumMaternal and Perinatal Health InterventionsMaternal and Neonatal Healthcare

Risk factors for postpartum depression: an umbrella review

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Xu, Min, Luo, Yuting, Huang, Yuehua, Liu, Yunxia, Ding, Lingling·2026·Frontiers in Public Health
DOI 10.3389/fpubh.2025.1714668PMC PMC12872911
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Abstract

Objective: This umbrella review aimed to systematically evaluate and synthesize the evidence on risk factors associated with postpartum depression (PPD), assess the methodological quality and credibility of the existing meta-analyses, and identify high-priority targets for prevention and intervention. Methods: We systematically searched PubMed, Embase, Web of Science, Cochrane Library, and Medicine up to March 2025 for systematic reviews and meta-analyses reporting on risk factors for PPD. Eligible studies were appraised using AMSTAR-2 and GRADE frameworks. Risk factors were categorized based on effect estimates, heterogeneity, publication bias, and evidence strength. Results: Seventy-seven meta-analyses were included, covering 53 unique risk factors. Among these, 40 showed statistically significant associations with PPD. Unintended pregnancy (OR: 1.55), intimate partner violence (OR: 2.50), poor social support (RR: 3.57), sleep disorders (OR: 2.36), and history of depression (OR: 3.09) emerged as the strongest risk factors. Protective factors included postpartum physical activity (SMD: −0.42), doula support (RR: 0.36), breastfeeding support (MD: −2.11), and parenting interventions (SMD: −0.34). Most evidence was rated as low or very low in certainty; only a few outcomes based on randomized controlled trials were graded as moderate to high quality. Conclusions: PPD is influenced by a broad spectrum of psychosocial, biological, and obstetric risk factors. Although many associations are supported by statistical significance, the overall evidence quality remains suboptimal. Targeted screening and preventive strategies should prioritize high-risk groups, while future research should focus on high-quality, prospective studies to establish causal links and improve maternal mental health outcomes. Systematic review registration: PROSPERO (Registration No.: CRD420251249033).

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Cited by

Sorted by citations

Authors
Xu, M., Luo, Y., Huang, Y., Liu, Y., & Ding, L.
Affiliations
The First Affiliated Hospital, Sun Yat-sen University (CN)
Corresponding author
Xu, Min
ORCID
Luo, Yuting
Venue
Frontiers in Public Health
Publisher
Frontiers Media SA
Published
2026-01-22
Volume
13
Pages
1714668-1714668
ISSN
2296-2565 (ISSN-L)
DOI
10.3389/fpubh.2025.1714668
PMC
PMC12872911
OpenAlex
W7125410970
Cited by
18
References
5
Citations by year
2026: 18
FWCI
22.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
postpartum depression, risk factors, unintended pregnancy, intimate partner violence, social support, sleep disorders, history of depression, postpartum exercise, doula support, breastfeeding support, parenting support, maternal mental health, prevention, screening
MeSH terms
Female, Humans, Pregnancy, Risk Factors, Social Support, Depression, Postpartum

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