Prevalence of Post-Partum Depression in India and Its Association with Risk Factors: A Systematic Review and Meta-Analysis

Authors

DOI:

https://doi.org/10.55489/njcm.160520255369

Keywords:

Depression, Pregnancy, Prevalence, Cohort, Cross-sectional

Abstract

Introduction: This study uses an exhaustive meta-analysis of descriptive epidemiological studies to determine the prevalence of major depression in post-partum females and its associated risk factors, across all ages in India.

Methodology: Using PRISMA guidelines, we searched PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies from 2020–2024. The review was registered in PROSPERO (CRD42024513914). Eligible English-language observational studies reported depression prevalence in perinatal Indian women. Meta-analysis was done using R (v4.3.0), and study quality was assessed with the JBI score. Pooled prevalence and odds ratios with 95% CI were calculated. Heterogeneity was evaluated using Q and I² statistics, and publication bias was assessed with Egger’s test and a funnel plot.

Results. Utilizing a random effects model, the results of 59 publications were used to estimate the prevalence of post-partum depression in India from 2020-2024 to be 19% (CI = 95: 15–23%). Meta-regression analysis found that older age post-partum females had a higher prevalence of post-partum depression as compared to young ones. Heterogeneity for prevalence was found to be 97%. The sub-group analysis found a higher prevalence of post-partum depression in Southern India (22%; 95% CI: 15–31), studies conducted in community settings (19%; 95% CI: 12–28), urban areas (19%; 95% CI: 15–24), studies using study instruments other than EPDS scale (22%; 95%CI: 11–39), and publication year 2024 (25%; 95% CI: 17-36).

Conclusion. Effective measures like psychological counselling and health education, need to be taken to control post-partum depression in India.

References

Beck CT. Postpartum depression: It isn't just the blues. Am J Nurs 2006; 106(5):40-50. DOI: https://doi.org/10.1097/00000446-200605000-00020

Upadhyay RV, Chowdhury R, Salehi A, et al. Postpartum depression in India: a systematic review and meta-analysis. Bull World Health Organ 2017; 95: 706-717. DOI: https://doi.org/10.2471/BLT.17.192237 PMid:29147043 PMCid:PMC5689195

Özcan NK, Boyacıoğlu NE and Dinç H. Postpartum depression prevalence and risk factors in Turkey: a systematic review and meta-analysis.Arch Psychiatr Nurs 2017; 31(4): 420-428. DOI: https://doi.org/10.1016/j.apnu.2017.04.006 PMid:28693880

Suhana Yahya NF, Teng NIMF, Das S, et al. Postpartum depression among neonatal intensive care unit mothers and its relation to postpartum dietary intake: a review. J Neonatal Nurs 2021;27(4):229-237. DOI: https://doi.org/10.1016/j.jnn.2020.09.005

Modi VP, Parikh MN, Valipay SK. A study on the prevalence of postpartum depression and correlation with risk factors. Ann Indian Psychiatry 2018;2(1):27-32. DOI: https://doi.org/10.4103/aip.aip_48_17

Panolan S, Thomas M B. Prevalence and associated risk factors of postpartum depression in India: A comprehensive review. J Neurosci Rural Pract. 2024 Jan-Mar;15(1):1-7. DOI: https://doi.org/10.25259/JNRP_584_2023 PMid:38476432 PMCid:PMC10927066

Bagedahl-Strindlund M. and Monsen B.K. Postnatal depression: A hidden illness. ActaPsychiatScandin.1998;98(4):272-5. DOI: https://doi.org/10.1111/j.1600-0447.1998.tb10083.x PMid:9821447

Vigod SN, Villegas L, Dennis CL, Ross LE: Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review. BJOG. 2010;117(5):540-50. DOI: https://doi.org/10.1111/j.1471-0528.2009.02493.x PMid:20121831

Milgrom J, Gemmill AW, Bilszta JL, et al.: Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1-2):147-57. DOI: https://doi.org/10.1016/j.jad.2007.10.014 PMid:18067974

Tajwar Y, Aman K, Shivani S, Shishir K, Sanjay K. Assessment of Magnitude and Risk Factors of Postpartum Depression among mothers attending immunization clinics of IGIMS, Patna. Int J Acad Med Pharm. 2024;6(2):1040-4.

Page M. J., McKenzie J. E., Bossuyt P. M., Boutron I., Hoffmann T. C., Mulrow C. D. et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews 2021. Bmj, 2021;372:n71. DOI: https://doi.org/10.31222/osf.io/v7gm2

Cohen J: Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 1968;70(4):213-220. DOI: https://doi.org/10.1037/h0026256 PMid:19673146

Munn Z, Moola S, Lisy K, Riitano D, & Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. International Journal of Evidence-Based Healthcare 2015;13(3):147-153. DOI: https://doi.org/10.1097/XEB.0000000000000054 PMid:26317388

Rajati, F., Ahmadi, N., Naghibzadeh, Z.-A.-S., & Kazeminia, M. The global prevalence of oropharyngeal dysphagia in different populations: A systematic review and meta-analysis. Journal of Translational Medicine 2022;20:175. DOI: https://doi.org/10.1186/s12967-022-03380-0 PMid:35410274 PMCid:PMC9003990

Bala J, Kumari R, Gupta RK, Langer B, Mahajan R, Zaffer I. Prevalence and Predictors of Postpartum Depression among Mothers Attending Tertiary Care Hospital, Jammu, India. Natl J Community Med 2024;15(8):642-648. DOI: https://doi.org/10.55489/njcm.150820244035

Begum S, S Anitha, Sushantha. A Cross-Sectional Study on Magnitude of Post-Partum Depression and Factors Associated with it among Postnatal Mothers Visiting a Tertiary Care Setting in Mangalore, Karnataka. Indian Journal of Public Health Research & Development. 2024 Jul 1;15(3):371-377. DOI: https://doi.org/10.37506/58n00148

Fatima N, Datta MR, Minhaz A. Evaluation of Mental Health in Postpartum Indian women-A Prospective hospital-based observational study. O&G Forum 2024;34(3s):2919-2921.

Kapoor B, Malik N, Gupta G, Khan IA. A cross-sectional study exploring postpartum depression at a tertiary care center in eastern Uttar Pradesh, India. Cureus. 2024;16(4):e58653. DOI: https://doi.org/10.7759/cureus.58653

Kar S, Samantaray PC, Patnaik L, Mishra A, Lakshmi P. Family and facility care variables attributing to postnatal depression among women in two tribal dominated districts of Odisha: Log model analysis to suggest intervention. J Family Med Prim Care 2024;13(3):958-63. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1367_23 PMid:38736796 PMCid:PMC11086792

Mhamane S, Karande Y, Ramanathan V. Post-partum depression: Its association with IYCF practices and effect on child growth indicators in urban slums of Mumbai, India. Clinical Epidemiology and Global Health. 2024;28:101667. DOI: https://doi.org/10.1016/j.cegh.2024.101667

Nyamagoud SB, Swamy AH, Fernandes L, Sultana S, Raj S, Hegde M, Tikadar D, Alex A, Kanavi R. Assessment of Postpartum Depression in Women Who Had Cesarean and Normal Vaginal Deliveries. International Journal of Pharmaceutical Investigation. 2024 Jan 1;14(1):165-171. DOI: https://doi.org/10.5530/ijpi.14.1.21

Pandey E, Mehta S, Garg S, Panigrahi S, Suneja A. Incidence of Postpartum Depression and Associated Risk Factors in Antenatal Women: A Cohort Study. Annals of Indian Psychiatry. 2025:9(1):18-22. DOI: https://doi.org/10.4103/aip.aip_160_23

Roy SK, Majumdar S, Singh R, Paul A. Prevalence and risk factors of depressive symptoms in the postpartum period: An experience from urban West Bengal, India. Journal of Family Medicine and Primary Care. 2024 Aug 1;13(8):2880-5. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1050_23 PMid:39228561 PMCid:PMC11368309

Surati B, Yogesh M, Munshi R, Vamja R. Bridging Hearts and Nurturing Bonds: A Holistic Exploration of Postpartum Depression, Social Support, and Breastfeeding Self-Efficacy among Women in Gujarat, India. Research Square; 2024, PREPRINT (Version 1). DOI: https://doi.org/10.21203/rs.3.rs-3908783/v1

Singh S, Kumari S. The prevalence and risk factors of postpartum depression among urban, low-income mothers: A retrospective study. Orapuh Journal. 2024 Jan 13;5(1): e1101.

More M, Agarwal A, Noorien R, Shetty C, Gopal S, Patil P. Incidence of depression in pregnant and postpartum women in tertiary care hospital using Edinburg postpartum depression scale: A prospective observational clinical study. MGM Journal of Medical Sciences. 2024 Jan 1;11(1):100-4. DOI: https://doi.org/10.4103/mgmj.mgmj_258_23

Bhakta M, Satapathy DM, Padhy M, Dalai S, Panda JN, Marandi P, Swamy SV, Pattnaik A. Assessing the prevalence and risk factors of postpartum depression: a cross-sectional study conducted in the urban areas of Ankuli in southern Odisha. Cureus. 2024;16(6): e61503. DOI: https://doi.org/10.7759/cureus.61503

Ruban JA, Santhosh A, Velmurugan M, Selvaraj L, Leela K, Subbarayan LM. Prevalence and Predictors of Anxiety and Depression among Perinatal Women in Tertiary Care Hospital: A Cross-Sectional Study. Journal of Health and Allied Sciences NU. 2024; 14(S 01): S89-S96 DOI: https://doi.org/10.1055/s-0044-1786692

Dadhwal V, Sagar R, Bhattacharya D, Kant S, Misra P, Choudhary V, et al. Prevalence of postpartum depression & anxiety among women in rural India: Risk factors & psychosocial correlates. Indian Journal of Medical Research. 2023 Oct 1;158(4):407-16. DOI: https://doi.org/10.4103/ijmr.IJMR_3489_20 PMid:37988000 PMCid:PMC10793822

Sunitha NH, Muktamath VU. Prevalence of Postpartum Depression and Associated Factors among the Postpartum Mothers in Vijayanagar District, Karnataka, India. Journal of Advances in Medicine and Medical Research. 2023 Sep 16;35(21):138-48. DOI: https://doi.org/10.9734/jammr/2023/v35i215220

Kumar LS, Latha PP, Naidu AR. Prevalence of Postpartum Depression among Postnatal Women Residing in Rural India. European Journal of Cardiovascular Medicine. 2023;13(3): 560.

Singh R, Jamir B, Vashum H. A study of the prevalence of post-partum depression in a secondary care hospital in Dimapur, Nagaland, Northeast India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023 Oct 1;12(10):3134-41. DOI: https://doi.org/10.18203/2320-1770.ijrcog20232961

Agarwal P, Dasari P, Sarkar S. Mode of delivery and postpartum depression: A cohort study. The Journal of Obstetrics and Gynecology of India. 2023 Oct;73(Suppl 1):88-96. DOI: https://doi.org/10.1007/s13224-023-01810-7 PMid:37916009 PMCid:PMC10616037

Leela K, Angamuthu PD, Mathew CT, Panicker AS, Shanmugham K. A Cross-Sectional Study of Postpartum Depression in a Tertiary Care Hospital in South India. Current Women's Health Reviews. 2023 Nov 1;19(4):48-56. DOI: https://doi.org/10.2174/1573404819666221108123556

Malhotra JK, Sidhu TK, Malhotra VM. Prevalence of postpartum depression and its psychosocial factors in district Bathinda. Adesh University Journal of Medical Sciences & Research. 2023 Jun 27;5(1):25-30. DOI: https://doi.org/10.25259/AUJMSR_10_2023

Tanna KJ, Unadkat KM. Socio-economic and Psychological Correlates of Postpartum Depression at Six Months. J Indian Med Assoc. 2023; 121(3): 21-4.

Akurathi P, Aligina KK, Rao RN, Rao UP, Poliyana GD, Thanuja P. Emotional wellness and Postpartum depression in the post-partum women within 49 hours of Child Birth, in a tertiary care hospital of a south Indian state. Int J Acad Med Pharm. 2023;5(3):1030-5.

Karra Saraga, Melachuru Sai Padma Charan, Ramchandran S and Balamma Sujatha, Postpartum Depression; A Survey of Mothers Attending Paediatric Outpatient Department in A Tertiary Care Centre.Int. J. Life Sci. Pharma Res. 2023;13(3), L103-L108. DOI: https://doi.org/10.22376/ijlpr.2023.13.3.L103-L108

Dalal A, Shetty A, Shetty R, Contractor A, Dordi M. Postpartum depression: a prospective observational cross-sectional study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023 Mar 1;12(3):609-14. DOI: https://doi.org/10.18203/2320-1770.ijrcog20230523

Priya T, Kaushal S, Dogra P, Dogra V. Prevalence and risk factors of postpartum depression in sub-Himalayan region. Medical Journal Armed Forces India. 2022 Feb 10; 80 (2):161-165. DOI: https://doi.org/10.1016/j.mjafi.2021.12.003 PMid:38525452 PMCid:PMC10954492

George M, Johnson AR and Sulekha T. Incidence of Postpartum Depression and Its Association with Antenatal Psychiatric Symptoms: A Longitudinal Study in 25 Villages of Rural South Karnataka. Indian J Psychol Med. 2022; 44(1):37-44. DOI: https://doi.org/10.1177/0253717621991061 PMid:35509654 PMCid:PMC9022929

Aslam M, Nawab T, Ahmad A, Abedi AJ, Azmi SA. Postpartum depression and its clinico social correlates - A community based study in Aligarh. Indian J Public Health 2022;66(4):473-9. DOI: https://doi.org/10.4103/ijph.ijph_1694_21 PMid:37039176

Chand S, Mukthamath VU, Pujar L, Channal E. Prevalence of postpartum depression among women in Bagalkot district of Karnataka. Journal of Farm Sciences. 2022 Jun 30;35(02):282-5.

Baruah J, Poonam. A Descriptive study to assess the prevalence of postnatal depression among postnatal mothers. Int J Scientific Research. Feb 2021;10(2): 14-15.

Ghormode PD, Sikdar MD, Ghormode D. Study on Prevalence of Postpartum Depression at our Tertiary Care Hospital. Journal of Cardiovascular Research. 2022;13(8):2244-2248

Hadia R, Bhavsar K, Patel R, Shivadas V, Gohel K, Gaikwad R, et al. A Prospective Observational Study to Find Out the Characteristics of Postpartum Depression (PPD) and to Assess the Impact of Pharmacist Led Counselling among the Females with PPD. J Young Pharm. 2022;14(2):214-20. DOI: https://doi.org/10.5530/jyp.2022.14.40

Mishra A, Arora G, Ogha A. Prevalence of postpartum psychiatric disorders in Northern Haryana and their relation to various socio-demographic factors. International Journal Dental and Medical Sciences Research. 2022; 4(4): 148-153.

Vishal AK, Prasad JVK, Bhasin D, Sharma SK, Kumar S, Sane SP. Prevalence of Post-Partum Depression and Factors Associated in a Tertiary Care Centre: A Cross-Sectional Study. Journal of Cardiovascular Disease Research. 2022; 13(8): 272-285

Ghosh S, Bhat S. Predicting and Identifying Postpartum Blues may be the key to implementing Preventive Approaches in Perinatal Mental Health: Findings from a Prospective, follow-up Study in India. Indian Journal of Public Health Research & Development. 2022 Oct 10;13(4):277-83. DOI: https://doi.org/10.37506/ijphrd.v14i4.18630

Lanjewar S, Nimkar S, Jungari S. Depressed motherhood: Prevalence and covariates of maternal postpartum depression among urban mothers in India. Asian journal of psychiatry. 2021 Mar 1; 57:102567. DOI: https://doi.org/10.1016/j.ajp.2021.102567 PMid:33581370

Dubey A, Chatterjee K, Chauhan VS, Sharma R, Dangi A, Adhvaryu A. Risk factors of postpartum depression. Ind Psychiatry J. 2021;30(Suppl 1): S127-31. DOI: https://doi.org/10.4103/0972-6748.328803 PMid:34908678 PMCid:PMC8611548

Doke PP, Vaidya VM, Narula APS, et al. Assessment of difference in postpartum depression among caesarean and vaginally delivered women at 6-week follow-up in hospitals in Pune District, India: an observational cohort study. BMJ Open. 2021;11: e052008. DOI: https://doi.org/10.1136/bmjopen-2021-052008 PMid:34593503 PMCid:PMC8487184

Randhawa A, Chaudhary N, Brar MS, Verma V, Munder SP. A community based cross sectional study to assess the prevalence of post partum depression: Why are the mothers depressed. J Family Med Prim Care 2021; 10(12):4536-41. DOI: https://doi.org/10.4103/jfmpc.jfmpc_2532_20 PMid:35280603 PMCid:PMC8884330

Basu S, Budh N, Garg S, Singh MM, Sharma A. Postpartum depression burden and associated factors in mothers of infants at an urban primary health center in Delhi, India. Tzu Chi Medical Journal. 2021 Jan 1;33(1):70-3. DOI: https://doi.org/10.4103/tcmj.tcmj_190_19 PMid:33505881 PMCid:PMC7821829

Neelakanthi A, Venkatesh S, Babu D, Nachiketha SR, Gopalakrishnan U. Prevalence and risk factors of depressive symptoms in the postpartum period: A cross-sectional study. Perinatology. 2021;21(4):166-73.

Kamath V, Ajila D, Shashirekha HD. Prevalence and risk factor analysis for postpartum depression: a cross-sectional study at the tertiary care center, Mangalore. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2021 Mar 1;10(3):988-93. DOI: https://doi.org/10.18203/2320-1770.ijrcog20210721

Chainani EG. Incidence of Postpartum Depression in a Tertiary Care Hospital in Navi Mumbai amid COVID-19 Pandemic. J South Asian Feder Obst Gynae. 2021;13(4): 240-244. DOI: https://doi.org/10.5005/jp-journals-10006-1918

Rahaney V, Faye A, Tadke R, Gawande S, Bhave SH, Kirpekar VC. Postpartum depression and its risk factors: A cross-sectional exploratory study. Ann Indian Psychiatry. 2021;5(1):36-42. DOI: https://doi.org/10.4103/aip.aip_3_21

Sita VK, Meenakshi. A Cross-Sectional Study on Prevalence of Postpartum Depression among Recently Delivered Women in a Tertiary Care Hospital, Chennai, India. Journal of Pharmaceutical Research International. 2021; 33(63B): 7-11. DOI: https://doi.org/10.9734/jpri/2021/v33i63B35246

Nayak D, Karuppusamy D, Maurya DK, Kar SS, Bharadwaj B, Keepanasseril A. Postpartum depression and its risk factors in women with a potentially life‐threatening complication. International Journal of Gynecology & Obstetrics. 2021 Sep;154(3):485-91. DOI: https://doi.org/10.1002/ijgo.13549 PMid:33338265

Naheeda MKT, Karunakaran L, Punnoose VP. Proportion and risk factors of postnatal depression among women delivering in a government tertiary care hospital in Kerala, India. Int J Reprod Contracept Obstet Gynecol. 2021;10(6):2395-402. DOI: https://doi.org/10.18203/2320-1770.ijrcog20212182

Bhaskar P, Yesikar V, Bansal SB, Waskel B. A cross-sectional study to assess the prevalence and risk factors of post-partum depression in the urban area of Indore district. Int J Res Med Sci 2021;9(10):3028-32. DOI: https://doi.org/10.18203/2320-6012.ijrms20213927

Rajendran SS, Ramasamy MR. Prevalence of Post Natal Depression and Risk Factors of Depression among Women Seeking Health Services in Southern India. Turkish Online Journal of Qualitative Inquiry. 2021 Aug;12(9):7970-6.

Raghavan V, Khan HA, Seshu U, Rai SP, Durairaj J, Aarthi G, Sangeetha C, John S, Thara R. Prevalence and risk factors of perinatal depression among women in rural Bihar: A community-based cross-sectional study. Asian Journal of Psychiatry. 2021 Feb 1; 56:102552. DOI: https://doi.org/10.1016/j.ajp.2021.102552 PMid:33454561 PMCid:PMC7896100

Amipara T, Baria H, Nayak S. A study on postpartum depression and its association with infant feeding practices and infant nutritional status among mothers attending the Anganwadi centers of Valsad district, Gujarat, India. Indian J Community Med. 2020;45(3):299-302. DOI: https://doi.org/10.4103/ijcm.IJCM_171_19 PMid:33354006 PMCid:PMC7745798

Santhosh K, Vinaychandran S, Narayan KD, Mini CH. Postpartum depression and its association with social support: a cross-sectional study at a maternity hospital in Kerala. Kerala Journal of Psychiatry. 2020 Jul 25;33(2):114-20. DOI: https://doi.org/10.30834/KJP.33.2.2020.198

Mishra K, Mohapatra I, Rout RN. An epidemiological study on depression among women during the postpartum period in an urban slum of Bhubaneswar. J Family Med Prim Care. 2020;9(9):4736-40. DOI: https://doi.org/10.4103/jfmpc.jfmpc_793_20 PMid:33209792 PMCid:PMC7652148

Rani K, Nandi N, Parmar SS, Rathore P. Prevalence and risk factor analysis postpartum depression in women: a cross-sectional study at tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2020;9(1):266-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20196031

Selvam G, Balasubramanian J, Mangolnganbi Chanu S. Frequency of postpartum depression among primi mothers undergoing delivery in JIPMER using Edinburgh postnatal depression scale. The New Indian Journal of OBGYN. 2020; 6(2):106-12. DOI: https://doi.org/10.21276/obgyn.2020.6.2.9

Priyanka S, Maiya R, Akram W. Prevalence of Postpartum Depression among the Mothers Visiting a Teaching Hospital Near Chennai. Índian Journal of Public Health. 2020 May;11(05):430-435.

Nigam S, Choudhary P. To determine the prevalence of postpartum depression in patients in RD Gardi Medical College, Ujjain. International Journal of Clinical Obstetrics and Gynaecology 2020; 4(5): 164-166. DOI: https://doi.org/10.33545/gynae.2020.v4.i5c.699

Goyal S, Gupta B, Sharma E, Dalal PK, Pradeep Y. Psychiatric morbidity, cultural factors, and health-seeking behaviour in perinatal women: a cross-sectional study from a tertiary care centre of North India. Indian Journal of Psychological Medicine. 2020 Jan;42(1):52-60. DOI: https://doi.org/10.4103/IJPSYM.IJPSYM_96_19 PMid:31997866 PMCid:PMC6970307

Tolossa T, Fetensa G, Yilma MT, Abadiga M, Wakuma B, Besho M, et al. Postpartum depression and associated factors among postpartum women in Ethiopia: a systematic review and meta-analysis, 2020. Public health reviews. 2020 Dec; 41:21. DOI: https://doi.org/10.1186/s40985-020-00136-3 PMid:32974057 PMCid:PMC7493842

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2025-05-01

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Gupta B, Grover K, Gupta S, Gupta K, Goel R, Mittal A. Prevalence of Post-Partum Depression in India and Its Association with Risk Factors: A Systematic Review and Meta-Analysis. Natl J Community Med [Internet]. 2025 May 1 [cited 2025 May 4];16(05):524-51. Available from: https://njcmindia.com/index.php/file/article/view/5369

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Systematic Review/ Meta Analysis