The prevalence and predictors of postpartum psychological outcomes among adolescent mothers: A systematic review and meta-analysis

<h2>Abstract</h2><h3>Background</h3> Adolescent pregnancy is a significant health issue that profoundly impacts the health, socioeconomic status, and psychological well-being of both the mother and the child. This review investigates the prevalence of postpartum psychological consequences and their predictors among adolescent mothers, providing crucial insights that can inform policies and interventions in maternal and child health. <h3>Methods</h3> This study is a systematic review and meta-analysis. A comprehensive search was conducted in various English-language databases, including PubMed, Embase, ProQuest, Scopus, CINAHL, and Web of Science. Additionally, Persian-language databases such as SID and Magiran were searched, along with Google Scholar. All available cross-sectional, case-control, and cohort studies examining the prevalence and predictors of psychological outcomes among adolescent mothers following childbirth were evaluated. Studies investigating the psychological effects of stillbirth or abortion, or measuring psychological outcomes with non-standard instruments, were excluded. Qualitative studies, interventional studies, letters to the editor, and studies on adult populations were also excluded. The search was unrestricted by time and extended until July 2023. The Newcastle-Ottawa Quality Assessment Scale was used to evaluate study quality. Analyses were conducted using STATA version 14.0. <h3>Results</h3> A total of 29 observational studies were included. Meta-analysis indicated that the prevalence (95% Confidence Interval) of postpartum depression and postpartum PTSD, using a random-effects model, was 0.31 (0.24–0.38) and 0.23 (0.14–0.31), respectively. Meta-analysis for stress prevalence was not conducted because only two studies addressed parental stress and psychological distress. There was a significant association between social and family support, the adolescent's education level, income, and postpartum psychological outcomes. Most of the included studies were of moderate to high quality, with seven rated as high, 11 as good, and the remaining 11 as satisfactory to unsatisfactory. <h3>Conclusion</h3> The estimated prevalence of postpartum depression and PTSD among adolescent mothers was 31% and 23%, respectively. The main predictors of postpartum psychological outcomes were socio-demographic variable.