Overall, most reports suggest that around 10% to 20% of new mothers will experience pospartum depression.[6]Wisner KL, Sit DK, McShea MC, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013 May;70(5):490-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440326
http://www.ncbi.nlm.nih.gov/pubmed/23487258?tool=bestpractice.com
[16]Wang Z, Liu J, Shuai H, et al. Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021 Oct 20;11(1):543.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528847
http://www.ncbi.nlm.nih.gov/pubmed/34671011?tool=bestpractice.com
[17]Gavin NI, Gaynes BN, Lohr KN, et al. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005 Nov;106(5 pt 1):1071-83.
http://www.ncbi.nlm.nih.gov/pubmed/16260528?tool=bestpractice.com
[18]Shorey S, Chee CYI, Ng ED, et al. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res. 2018 Sep;104:235-48.
http://www.ncbi.nlm.nih.gov/pubmed/30114665?tool=bestpractice.com
Reported prevalence is generally lower in high-income countries (6.9% to 12.9%) compared with low- or middle-income countries (20%).[11]Howard LM, Molyneaux E, Dennis CL, et al. Non-psychotic mental disorders in the perinatal period. Lancet. 2014 Nov 15;384(9956):1775-88.
http://www.ncbi.nlm.nih.gov/pubmed/25455248?tool=bestpractice.com
[19]Roddy Mitchell A, Gordon H, Lindquist A, et al. Prevalence of perinatal depression in low- and middle-income countries: a systematic review and meta-analysis. JAMA Psychiatry. 2023 May 1;80(5):425-31.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2802140
http://www.ncbi.nlm.nih.gov/pubmed/36884232?tool=bestpractice.com
According to one systematic review, the mean prevalence in eight African countries appears to be around 18.3%.[20]Sawyer A, Ayers S, Smith H. Pre- and postnatal psychological wellbeing in Africa: a systematic review. J Affect Disord. 2010 Jun;123(1-3):17-29.
http://www.ncbi.nlm.nih.gov/pubmed/19635636?tool=bestpractice.com
One large review of 143 studies from 40 countries reports a wide range in the prevalence of postpartum depression worldwide, ranging from 0% to 60%.[21]Halbreich U, Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J Affect Disord. 2006 Apr;91(2-3):97-111.
http://www.ncbi.nlm.nih.gov/pubmed/16466664?tool=bestpractice.com
It is unclear whether the wide range in reported prevalence in the studies above is related to cultural differences or to the heterogeneity between studies in defining and assessing depression.[22]Di Florio A, Putnam K, Altemus M, et al. The impact of education, country, race and ethnicity on the self-report of postpartum depression using the Edinburgh Postnatal Depression Scale. Psychol Med. 2017 Apr;47(5):787-99.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369767
http://www.ncbi.nlm.nih.gov/pubmed/27866476?tool=bestpractice.com
There is some evidence that exposure to a culture that emphasizes family support for the mother in the first month following childbirth is associated with lower rates of postpartum depression.[23]Halbreich U. Postpartum disorders: multiple interacting underlying mechanisms and risk factors. J Affect Disord. 2005 Sep;88(1):1-7.
http://www.ncbi.nlm.nih.gov/pubmed/15996747?tool=bestpractice.com
Symptom onset in pregnancy (and before pregnancy) is not uncommon; therefore, the term "perinatal depression" may be strictly more accurate.[6]Wisner KL, Sit DK, McShea MC, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013 May;70(5):490-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440326
http://www.ncbi.nlm.nih.gov/pubmed/23487258?tool=bestpractice.com
[7]Biaggi A, Conroy S, Pawlby S, et al. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016 Feb;191:62-77.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879174
http://www.ncbi.nlm.nih.gov/pubmed/26650969?tool=bestpractice.com
Studies examining comorbidity suggest that postpartum depression frequently occurs concurrently with other psychiatric disorders occurring in the postpartum period, particularly anxiety disorders.[24]Figueira P, Fernandes Malloy-Diniz L, Aurélio Romano-Silva M, et al. Postpartum depression and comorbid disorders: frequency and relevance to clinical management. Arch Womens Ment Health. 2009 Dec;12(6):451.
http://www.ncbi.nlm.nih.gov/pubmed/19730980?tool=bestpractice.com
[25]Le Strat Y, Dubertret C, Le Foll B. Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disord. 2011 Dec;135(1-3):128-38.
http://www.ncbi.nlm.nih.gov/pubmed/21802737?tool=bestpractice.com
The prevalence of comorbid depression and anxiety within the postpartum period has been reported as 4.2%.[26]Falah-Hassani K, Shiri R, Dennis CL. The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychol Med. 2017 Sep;47(12):2041-53.
http://www.ncbi.nlm.nih.gov/pubmed/28414017?tool=bestpractice.com
Postpartum depression is an important risk factor for maternal suicide.[27]Khalifeh H, Hunt IM, Appleby L, et al. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry. 2016 Mar;3(3):233-42.
http://www.ncbi.nlm.nih.gov/pubmed/26781366?tool=bestpractice.com
Maternal suicide is a leading cause of maternal mortality, and is believed to account for approximately 20% of maternal deaths in the postpartum period.[28]Knight M. MBRRACE-UK perinatal mortality surveillance report UK perinatal deaths for births from January to December 2020. 2021 [internet publication].[29]Johannsen BM, Larsen JT, Laursen TM, et al. All-cause mortality in women with severe postpartum psychiatric disorders. Am J Psychiatry. 2016 Jun 1;173(6):635-42.
https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.14121510?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
http://www.ncbi.nlm.nih.gov/pubmed/26940804?tool=bestpractice.com
[30]Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005 Jun;8(2):77-87.
http://www.ncbi.nlm.nih.gov/pubmed/15883651?tool=bestpractice.com