Clinical and Medical Engineering Live
ISSN: 2997-612X | DOI: 10.64030/2997-612X
Kiptoo Aron Koros*, Joan Nyabuga Arisi, Musa kasujja, Okurut Emmanuel, Theoneste hakizimana, RihaamAbshir, Stellamaris Muthue Andrew, Nabushawo Faith and Kyeroba Martin
Background: Postpartum depression (PPD) is a prevalent mental health condition affecting women post-childbirth, with a higher burden in low- and middle-income countries (LMICs). Hypertensive Disorders of Pregnancy (HDP), including gestational hypertension, preeclampsia, and eclampsia, are linked to increased PPD risk due to biological and psychological stressors. This study estimates the prevalence of PPD among women with HDP in LMICs and explores associated factors.
Methods: A systematic review was conducted following PRISMA guidelines, with the protocol registered on PROSPERO (CRD420251058350). PubMed, Scopus, Web of Science, and Lens.org were searched from inception to April 2025 for observational studies reporting PPD prevalence among women with HDP in LMICs. Data were extracted using the Joanna Briggs Institute tool (quality score ≥6/9). A random-effects meta-analysis with logit transformation estimated pooled prevalence. Heterogeneity (I², τ², Q), publication bias (Egger’s test, Kendall’s tau, funnel plot), and equivalence testing (TOST) were assessed using R (version 4.4.1).
Results: From 302 records, 8 studies (1,325 women) from five LMICs (Brazil, China, Iran, Pakistan, Tanzania), and one highincome country England [outlier]) were included after screening and eligibility assessment. The pooled PPD prevalence was 27.51% (95% CI: 18.54–38.37%, p < 0.001), significantly higher than in normotensive women (15–20%). Heterogeneity was moderate (I² = 62.19%, τ² = 0.3264, Q = 18.293, p = 0.011). Urban and rural prevalence rates were comparable (p = 0.21). No publication bias was detected (Egger’s p = 0.220).
Conclusions: Approximately one in four women with HDP in LMICs experiences PPD, underscoring a critical public health issue. Routine PPD screening and targeted mental health interventions are urgently needed in LMIC healthcare settings. Given the limited data from sub-Saharan Africa, further research in this region is essential to address regional disparities and inform tailored interventions.