Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: A systematic review

Jane Rosamond Woodward Fisher, Meena Cabral de Mello, Vikram Patel, Atif Rahman, Thach Tran, Sara Holton, Wendy Holmes

Research output: Contribution to journalArticleResearchpeer-review

520 Citations (Scopus)

Abstract

Objective: To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low-and lower-middle-income countries.
Methods: Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included.
Findings: Thirteen papers covering 17 low and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8 ) countries, and on disorders in the postnatal period, for 17 (15 ). Weighted mean prevalence was 15.6 (95 confidence interval, CI: 15.4-15.9) antenatally and 19.8 (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95 CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95 CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95 CI: 0.3-0.9).
Conclusion: CPMDs are more prevalent in low-and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.
Original languageEnglish
Pages (from-to)139 - 149
Number of pages11
JournalBulletin of the World Health Organization
Volume90
Issue number2
DOIs
Publication statusPublished - 2012

Cite this

@article{6e32130638c6494f9281d10cb2faa530,
title = "Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: A systematic review",
abstract = "Objective: To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low-and lower-middle-income countries. Methods: Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Findings: Thirteen papers covering 17 low and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8 ) countries, and on disorders in the postnatal period, for 17 (15 ). Weighted mean prevalence was 15.6 (95 confidence interval, CI: 15.4-15.9) antenatally and 19.8 (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95 CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95 CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95 CI: 0.3-0.9). Conclusion: CPMDs are more prevalent in low-and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.",
author = "Fisher, {Jane Rosamond Woodward} and {de Mello}, {Meena Cabral} and Vikram Patel and Atif Rahman and Thach Tran and Sara Holton and Wendy Holmes",
year = "2012",
doi = "10.2471/BLT.11.091850",
language = "English",
volume = "90",
pages = "139 -- 149",
journal = "Bulletin of the World Health Organization",
issn = "0042-9686",
publisher = "World Health Organization",
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Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries : A systematic review. / Fisher, Jane Rosamond Woodward; de Mello, Meena Cabral; Patel, Vikram; Rahman, Atif; Tran, Thach; Holton, Sara; Holmes, Wendy.

In: Bulletin of the World Health Organization, Vol. 90, No. 2, 2012, p. 139 - 149.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries

T2 - A systematic review

AU - Fisher, Jane Rosamond Woodward

AU - de Mello, Meena Cabral

AU - Patel, Vikram

AU - Rahman, Atif

AU - Tran, Thach

AU - Holton, Sara

AU - Holmes, Wendy

PY - 2012

Y1 - 2012

N2 - Objective: To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low-and lower-middle-income countries. Methods: Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Findings: Thirteen papers covering 17 low and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8 ) countries, and on disorders in the postnatal period, for 17 (15 ). Weighted mean prevalence was 15.6 (95 confidence interval, CI: 15.4-15.9) antenatally and 19.8 (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95 CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95 CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95 CI: 0.3-0.9). Conclusion: CPMDs are more prevalent in low-and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.

AB - Objective: To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low-and lower-middle-income countries. Methods: Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Findings: Thirteen papers covering 17 low and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8 ) countries, and on disorders in the postnatal period, for 17 (15 ). Weighted mean prevalence was 15.6 (95 confidence interval, CI: 15.4-15.9) antenatally and 19.8 (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95 CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95 CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95 CI: 0.3-0.9). Conclusion: CPMDs are more prevalent in low-and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.

UR - http://www.who.int/bulletin/volumes/90/2/11-091850/en/index.html

U2 - 10.2471/BLT.11.091850

DO - 10.2471/BLT.11.091850

M3 - Article

VL - 90

SP - 139

EP - 149

JO - Bulletin of the World Health Organization

JF - Bulletin of the World Health Organization

SN - 0042-9686

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