Prevalence and risk factors of perinatal depression among women in South Asian countries:A systematic review and meta-analysis

BACKGROUND: More than one-third of South Asian women of reproductive age experience mental health issues during the perinatal period. We aim to systematically summarise existing evidence to conduct a meta-analysis to estimate the prevalence and key risk factors for perinatal depression in South Asia. METHODS: We searched across multiple databases for prospective studies that reported the prevalence of perinatal depression and/or associated risk factors among women in South Asian countries. We performed a meta-analysis of estimates of the prevalence of perinatal depression-related outcomes and associated risk factors (odds ratios) using random-effects models. Meta-regression and subgroup analyses were performed to explore the source of heterogeneity. RESULTS: The systematic review and meta-analysis included 29 studies published between 2015 and 2024. The overall pooled prevalence of perinatal depression was 28 % (95 % CI 24 % to 32 %; I 2 = 95.1 %, p ≤0.001). The prevalence varied widely by country, where the pooled prevalence of perinatal depression was highest in Bangladesh (46 %) and lowest in Sri Lanka (15 %). Son preference was identified as a risk factor for perinatal depression (OR 2.6, 95 % CI 1.6 to 4.2, I 2 = 26 %). Lack of family support, unwanted pregnancy, women's history of health problems, and poor economic conditions were key predictors of perinatal depression. CONCLUSIONS: The prevalence of perinatal depression in South Asian countries is high and caused by a combination of multiple risk factors. Targeted intervention, particularly on social norms around son preference and family support, is probably effective in addressing perinatal mental health risks during pregnancy and postpartum periods.