Early motherhood, early burden: depression among teenage pregnancy and early motherhood in Africa: a systematic review and meta-analysis.

INTRODUCTION: Teenage pregnancy is a major public health concern closely linked to depression, and maternal depression remains a significant challenge in Africa due to its adverse effects on mothers, infants, and families. Evidence on depression during teenage pregnancy and early motherhood in Africa is inconsistent, and no prior global or regional meta-analysis has synthesized pooled prevalence estimates in this population. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of depression and its associated factors among teenage pregnancy and early motherhood in Africa. METHODS: A systematic search was conducted in PubMed, CINAHL, EMBASE, the Cochrane Library, African Journals Online, and HINARI. Study quality was assessed using the Joanna Briggs Institute critical appraisal. Pooled estimates were calculated with a random-effects model, heterogeneity was evaluated using the I² statistic, and publication bias was assessed using funnel plots and Egger’s test, with p < 0.05 considered statistically significant. RESULTS: A total of 27 studies involving 11,461 adolescents experiencing teenage pregnancy and early motherhood were included. The pooled prevalence of depression was 40.06% (95% CI: 29.81,51.37). Depression was significantly associated with intimate partner violence (AOR = 2.52; 95% CI: 1.30, 4.84), food insecurity (AOR = 2.64; 95% CI: 1.94, 3.60), being unmarried (AOR = 1.55; 95% CI: 1.09, 2.20), poor social support (AOR = 1.88; 95% CI: 1.08, 3.20), substance use (AOR = 2.23; 95% CI: 1.43, 3.50), and having no formal education (AOR = 2.68; 95% CI: 1.24, 5.80). Subgroup analysis showed that a higher prevalence of depression during the postpartum period 48.66% compared with the antenatal period 39.81%, while low income countries reported lower prevalence of depression with 28.54%. The highest pooled prevalence of depression was shown in central Africa with 65.44%. CONCLUSION: Depression is highly prevalent among adolescents experiencing teenage pregnancy and early motherhood in Africa, with particularly higher rates observed during the postpartum period, while lower-income countries report comparatively lower prevalence. Targeted interventions addressing the identified risk factors should be integrated into obstetric care during adolescence and mental health care services. PROSPERO REGISTRATION NUMBER: CRD420261282274.