Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis

Abstract Introduction Postpartum depression (PPD) is a growing mental health concern worldwide and has detrimental effects on the social and cognitive health of both mothers and infants. This review was performed to assess the risk of PPD in women with postpartum hemorrhage (PPH) and to identify pot...

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Main Authors: Bo Sheng, Guoguo Jiang, Juan Ni
Format: Article
Language:English
Published: Wiley 2024-07-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14795
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author Bo Sheng
Guoguo Jiang
Juan Ni
author_facet Bo Sheng
Guoguo Jiang
Juan Ni
author_sort Bo Sheng
collection DOAJ
description Abstract Introduction Postpartum depression (PPD) is a growing mental health concern worldwide and has detrimental effects on the social and cognitive health of both mothers and infants. This review was performed to assess the risk of PPD in women with postpartum hemorrhage (PPH) and to identify potential moderators. Material and methods The review protocol was registered in the PROSPERO database on June 17, 2023 (registration number: CRD42023432955). Two researchers independently performed a literature search of the PubMed, Embase, and Web of Science databases for articles published before May 25, 2023, with no filters and no language or location restrictions. Study quality was evaluated using the Newcastle–Ottawa Scale. The primary outcome was the odds ratio (OR) and 95% confidence interval (CI) of PPD in women with vs. without PPH. We performed sensitivity analyses and meta‐regression analyses to resolve heterogeneity. Meta‐regression analyses included the effects of age, maternal smoking, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, and cesarean section. Results In total, seven studies involving 540 558 participants met the eligibility criteria and were included in the meta‐analysis. Women with PPH were at increased risk of PPD compared with women without PPH (OR 1.10; 95% CI 1.03–1.16), and heterogeneity was low (I2 = 23%; τ2 = 0.0007; p = 0.25). Moreover, the results of the sensitivity analyses showed that the I2 value decreased from 23% to 0% after excluding one particular study, which may have been a source of heterogeneity. In the meta‐regression analyses, the OR of PPD was greatly affected by maternal smoking (OR −0.26; 95% CI −0.30 to −0.22; p < 0.001). However, we did not observe any effects for maternal age, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, or cesarean section. Conclusions Women with PPH must be closely monitored because they have a higher risk of PPD than women without PPH. Early recognition and management of these patients will improve treatment outcomes, maternal health, and newborn development.
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spelling doaj-art-0ba8cf74a4e542058216c40f2c3919b92025-08-20T03:30:57ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-07-0110371263127010.1111/aogs.14795Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysisBo Sheng0Guoguo Jiang1Juan Ni2Department of Anesthesiology West China Second University Hospital, Sichuan University City of Chengdu Sichuan ChinaDepartment of Hospital Infection Management The Second Hospital of Chengdu City City of Chengdu Sichuan ChinaDepartment of Anesthesiology West China Second University Hospital, Sichuan University City of Chengdu Sichuan ChinaAbstract Introduction Postpartum depression (PPD) is a growing mental health concern worldwide and has detrimental effects on the social and cognitive health of both mothers and infants. This review was performed to assess the risk of PPD in women with postpartum hemorrhage (PPH) and to identify potential moderators. Material and methods The review protocol was registered in the PROSPERO database on June 17, 2023 (registration number: CRD42023432955). Two researchers independently performed a literature search of the PubMed, Embase, and Web of Science databases for articles published before May 25, 2023, with no filters and no language or location restrictions. Study quality was evaluated using the Newcastle–Ottawa Scale. The primary outcome was the odds ratio (OR) and 95% confidence interval (CI) of PPD in women with vs. without PPH. We performed sensitivity analyses and meta‐regression analyses to resolve heterogeneity. Meta‐regression analyses included the effects of age, maternal smoking, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, and cesarean section. Results In total, seven studies involving 540 558 participants met the eligibility criteria and were included in the meta‐analysis. Women with PPH were at increased risk of PPD compared with women without PPH (OR 1.10; 95% CI 1.03–1.16), and heterogeneity was low (I2 = 23%; τ2 = 0.0007; p = 0.25). Moreover, the results of the sensitivity analyses showed that the I2 value decreased from 23% to 0% after excluding one particular study, which may have been a source of heterogeneity. In the meta‐regression analyses, the OR of PPD was greatly affected by maternal smoking (OR −0.26; 95% CI −0.30 to −0.22; p < 0.001). However, we did not observe any effects for maternal age, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, or cesarean section. Conclusions Women with PPH must be closely monitored because they have a higher risk of PPD than women without PPH. Early recognition and management of these patients will improve treatment outcomes, maternal health, and newborn development.https://doi.org/10.1111/aogs.14795postpartum depressionpostpartum hemorrhagepostpartum psychosispregnancysystematic review
spellingShingle Bo Sheng
Guoguo Jiang
Juan Ni
Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis
Acta Obstetricia et Gynecologica Scandinavica
postpartum depression
postpartum hemorrhage
postpartum psychosis
pregnancy
systematic review
title Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis
title_full Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis
title_fullStr Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis
title_full_unstemmed Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis
title_short Association between postpartum depression and postpartum hemorrhage: A systematic review and meta‐analysis
title_sort association between postpartum depression and postpartum hemorrhage a systematic review and meta analysis
topic postpartum depression
postpartum hemorrhage
postpartum psychosis
pregnancy
systematic review
url https://doi.org/10.1111/aogs.14795
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