Prevalence of postpartum depression at subnational level in India: A systematic review and meta-analysis

Postpartum depression is highly prevalent among expectant and new mothers and has far-reaching implications for the well-being of both mother and child. In this context, the present study attempts to estimate the prevalence of postpartum depression in India at national and sub-national levels. We performed a systematic literature search in PubMed, Scopus, and EMBASE, including studies published between 2015 and 2023. Inclusion criteria encompassed research conducted in India, focusing on mothers from delivery up to one year postpartum. Observational studies reporting event numbers and total participants were included. The random-effects model was used. Sensitivity and subgroup analyses were conducted. The review analyzed 62 studies involving 21,262 women. The prevalence of postpartum depression was estimated to be 23.5 percent (95 percent CI: [19.3 percent-28.2 percent]) in India. We observed a substantial heterogeneity (I2 = 96.9 percent). Doi plot results showed an insignificant small study effect (Luis Furuya-Kanamori asymmetry index of -0.03). We identified significant associations between postpartum depression prevalence and various factors, including Indian states, study settings, literature quality score, publication year, and study period. In response to the findings, the study recommends targeted interventions, improved access to mental health services, and integrated mental health services with routine antenatal and postnatal care.