India’s Silent Struggle: A Scoping Review on Postpartum Depression in the Land of a Billion Mothers

Rajeev S. P., Gokul M. Nair, Krishna K. K., Chris Maria
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Abstract

Postpartum emotional issues, including postpartum blues, postpartum psychosis, and postpartum depression (PPD), affect many mothers worldwide. The prevalence of postpartum blues ranges from 300 to 750 per 1,000 mothers, while postpartum psychosis has a prevalence of 0.89–2.6 cases per 1,000 births. PPD affects 100–150 new mothers per 1,000 births, and its prevalence can go above 25% globally. Depression in mothers can have long-lasting impacts on children and the next generation, affecting their growth, development, and relationships. However, the condition of PPD is frequently misdiagnosed, and women who suffer from it do not receive treatment. There is a lack of solid systematic evidence that looks at the overall burden of PPD and the risk factors that are associated with it in India. The awareness of PPD is critical in managing the symptoms and seeking professional support, and studies are needed to evaluate and assess the situation in India. This study is a systematic literature review with a scoping review approach aimed at providing existing evidence on the awareness and prevalence of PPD in India. The search strategy for the electronic bibliographic search included a list of related terms and factors of awareness and prevalence of PPD. The search encompassed six prominent databases. The assessment tools used in studies from 2012 to 2023 study the factors using the Postpartum Depression Literacy Scale (PoDLiS) and the Edinburgh Postpartum Depression Scale, which measure the awareness and prevalence of PPD. The study found a significantly low volume of studies conducted in India to determine the prevalence of PPD. The materials or studies accessible are hospital-based research with a minimal number of samples. The reported prevalence rate of postpartum depression (PPD) in India varies across different studies, ranging from 4% to 48.5%. Among mothers who gave birth either naturally or by cesarean section in a hospital setting, one study reported the lowest prevalence rate (4%). The prevalence of PPD among women in India is estimated to be 18% based on the average score across all research. A study that evaluated the moms in the community found that PPD was prevalent in new mothers at a rate of 21.5%. There are three studies, in particular, that focus on how aware people are of PPD. Two studies found that 54% of the family members of postpartum moms and women undergoing tertiary pediatric care are aware of PPD. Many studies point to the lack of social support as a significant risk factor for mental health complications after delivery. History of depression, anxiety, adverse life events, partner abuse, low economic status, complications at childbirth, and a traumatic childbirth experience are some of the associated factors identified in the studies. Studies have also shown that women who undergo a cesarean section have a higher risk of developing PPD than those with a vaginal delivery.
印度的无声斗争:十亿母亲之国的产后抑郁症范围综述
产后情绪问题,包括产后忧郁症、产后精神病和产后抑郁症(PPD),影响着全世界的许多母亲。产后忧郁症的发病率为每千名母亲 300 到 750 例,而产后精神病的发病率为每千名新生儿 0.89 到 2.6 例。每 1,000 名新生儿中就有 100-150 名新妈妈患上 PPD,全球发病率可超过 25%。母亲抑郁会对孩子和下一代产生长期影响,影响他们的成长、发育和人际关系。然而,PPD 经常被误诊,患有这种疾病的妇女也得不到治疗。在印度,目前还缺乏可靠的系统性证据来研究 PPD 的总体负担以及与之相关的风险因素。对 PPD 的认识对于控制症状和寻求专业支持至关重要,因此需要开展研究来评估印度的情况。本研究是一项系统性文献综述,采用了范围界定方法,旨在提供有关印度对 PPD 的认识和患病率的现有证据。电子文献检索的搜索策略包括一份相关术语和因素清单,内容涉及PPD的认知度和流行率。搜索涵盖了六个著名的数据库。2012 年至 2023 年的研究中使用的评估工具是产后抑郁素养量表(PoDLiS)和爱丁堡产后抑郁量表(Edinburgh Postpartum Depression Scale),它们用于测量产后抑郁的认知度和患病率。研究发现,印度在确定产后抑郁症患病率方面开展的研究数量明显偏低。可获得的资料或研究都是基于医院的研究,样本数量极少。不同研究报告的印度产后抑郁症(PPD)患病率各不相同,从 4% 到 48.5% 不等。在医院自然分娩或剖腹产的母亲中,一项研究报告的患病率最低(4%)。根据所有研究的平均得分,印度妇女的 PPD 患病率估计为 18%。一项对社区妈妈进行评估的研究发现,PPD 在新妈妈中的流行率为 21.5%。有三项研究特别关注了人们对 PPD 的认识程度。有两项研究发现,54% 的产后妈妈和接受三级儿科护理的妇女的家庭成员了解 PPD。许多研究指出,缺乏社会支持是产后精神健康并发症的一个重要风险因素。抑郁史、焦虑、不良生活事件、伴侣虐待、经济地位低下、分娩并发症和创伤性分娩经历是研究中发现的一些相关因素。研究还表明,与阴道分娩的产妇相比,剖宫产的产妇患 PPD 的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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