Postpartum Depression in The Arab Region: A Systematic Literature Review Original paper

What was reviewed?

Thi review focused on the prevalence and risk factors of postpartum depression (PPD) in Arab countries. The review analyzed 25 studies that were published until February 2016, assessing PPD among mothers in various Arab countries. The studies included a combination of longitudinal and cross-sectional designs and investigated the various risk factors associated with PPD in the region. The primary aim was to determine the prevalence of PPD among Arab mothers and identify common risk factors such as socioeconomic status, obstetric complications, unwanted pregnancies, and family dynamics.

Who was reviewed?

The review focused on studies that examined PPD among mothers in Arab countries. The mothers studied were from diverse backgrounds, including urban and rural areas, and a range of socioeconomic statuses. These studies were conducted across various Arab countries, including the United Arab Emirates, Saudi Arabia, Morocco, Lebanon, Egypt, Palestine, and others. The review considered studies that used tools like the Edinburgh Postnatal Depression Scale (EPDS), Mini-International Neuropsychiatric Interview (MINI), and Beck Depression Inventory (BDI) to assess the prevalence of PPD. These studies often considered both cultural and socio-economic variables, such as marital conflict, low income, and pregnancy complications, as potential risk factors for PPD.

What were the most important findings?

The review found that the prevalence of PPD in Arab countries varied widely, with some studies reporting prevalence rates as low as 8% and others as high as 74%. The majority of studies indicated a prevalence rate between 15-25%, consistent with rates found in other low and lower-middle-income countries. The studies revealed that the most significant risk factors for PPD in the Arab region included low socioeconomic status, unwanted pregnancies, marital and family conflicts, obstetric complications during pregnancy, and lack of social and partner support. Additionally, studies indicated that mothers who had infants with health issues, low birth weight, or who were formula-fed were more likely to experience PPD. Family dynamics, such as conflict with in-laws or lack of support from the husband, were also strong indicators. Several studies also noted that a history of depression, both personal and familial, significantly increased the likelihood of developing PPD.

What are the greatest implications of this review?

This review underscores the need for systematic interventions to address PPD in Arab countries. The high prevalence rates across the region emphasize the importance of integrating routine screening for PPD into postpartum care. Furthermore, the identification of socio-cultural and economic factors as major risk contributors suggests that culturally sensitive and appropriate mental health services must be developed and implemented. The review calls for policies that promote social support for new mothers, including improving marital relationships and reducing socioeconomic stress. The review also advocates for better training for healthcare providers to recognize and manage PPD, along with more widespread use of validated diagnostic tools such as the EPDS. In addition, the review highlights the need for more longitudinal studies to better understand the trajectory of PPD and its long-term effects on both mothers and their infants.