Perinatal depression in India: A narrative review of prevalence, risk factors, and healthcare provider awareness.

Abstract

Background: Perinatal depression (PND), encompassing both antenatal and postnatal depression, affects 10%-20% women globally, with reported higher rates in low- and middle-income countries, like India. In India, PND prevalence varies widely (15%-45%), influenced by regional, cultural, and socioeconomic factors. Untreated PND has severe consequences for maternal health, child development, and family dynamics. Healthcare workers (HCWs) play a vital role in early detection, yet awareness and training in India are insufficient.

Objective: This review aims to synthesize evidence on prevalence and risk factors of PND in India, assess awareness levels and preparedness among HCWs in managing PND and identify barriers to effective detection and management of PND.

Methods: A comprehensive literature search was done in PubMed and Google Scholar for studies published between 2014 and 2024. Inclusion criteria involved studies from India focusing on PND prevalence, risk factors, and HCW awareness. Data extraction, involved study characteristics, prevalence rates, risk factors, HCW awareness. Quality for observational studies was assessed using Newcastle-Ottawa Scale and for systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: PND prevalence in India ranged from 15% to 45%, with significant regional variations. Major risk factors included poverty, domestic violence, unplanned pregnancies, and limited spousal support. HCWs demonstrated low awareness, with only 30% of nurses confident in identifying PND symptoms. Barriers to effective management, included cultural stigma, limited mental health training for HCWs, and inadequate healthcare infrastructure. Successful interventions included the use of validated screening tools like the Edinberg Postnatal Depression Scale (EPDS) and community-based support systems.

Conclusion: PND remains a significant public health issue in India, exacerbated by sociocultural stigma and healthcare gaps. Integrated mental health services, HCW training, and culturally sensitive interventions are essential to improving PND care. Addressing these issues can reduce maternal and child health disparities and improve outcomes in resource-limited settings.