Abstract

Introduction: Perinatal depression is associated with intrauterine growth retardation, preterm birth and low birth weight. Infant born to mothers with perinatal depression may suffer from malnutrition and other health problems. Even though there are few single studies conducted so far, a systematic review of these studies is highly important to highlight the effect of perinatal depression on birth and infant health outcome in Africa.

Methods: We used the Preferred Report Items for Systematic Review and Meta-analysis (PRISMA) when conducting this study. Databases CINAHL (EBSCO), MEDLINE (via Ovid), PsycINFO, Emcare, PubMed, Psychiatry Online, and Scopus were searched as well as Google Scholar and  references from a list of eligible studies. We included observational studies published between 2007 and 2018, in English language and with good quality based on Newcastle Ottawa Scale. Heterogeneity and publication bias were assessed. Meta-analysis with a random effect model was employed to determine the pooled effect size with 95% confidence interval. The review protocol has been registered in PROSPERO number CRD42018106714.

Result: We included three studies (1,511 participants) and 11 studies (22,254 participants) to determine the effect of antenatal depression on birth outcomes and perinatal depression on adverse infant health outcomes, respectively. The risk of having adverse birth outcome was 2.26 (95% CI: 1.43, 3.58) times higher among pregnant mothers with depression. From this, the risk of preterm birth and low birth weight was 1.77 (95% CI: 1.03, 3.04) and 2.98 (95% CI: 1.60, 5.55) times, respectively. Similarly, the risk of having adverse infant health outcomes (malnutrition and febrile illness) was 1.61 (95% CI: 1.34, 1.95) times higher among mothers with perinatal depression.

Conclusions: We have found a significant association between perinatal depression and adverse birth and infant health outcomes.  The most commonly associated outcomes were preterm birth, low birth weight, malnutrition, and febrile illnesses.

Keywords: Antenatal depression, Postnatal depression, Adverse birth outcomes, Adverse infant health outcomes, Systematic review, Meta-analysis