Risk factors of post-partum depression among Malaysian women from 2011 to 2023: A systematic review and meta-analysis.

BACKGROUND: Postpartum depression (PPD) is a significant psychiatric condition and is one of the largest contributors to pregnancy-related morbidity and mortality. This study aims to perform a systematic review and meta-analysis to evaluate and quantify the effect of expected risk factors for PPD that are unique to Malaysian women. METHODOLOGY: Primary sources (Ovid Medline, Wiley Online Library, Cochrane, and Scopus databases) and secondary sources (ProQuest library and grey literature) were scanned. Peer-reviewed studies were included in this review using Mendeley® Reference Manager. Using PRISMA 2020 guidelines, online databases were searched for studies that reported risk factors for PPD in Malaysia from 2011 to 2023. Data extraction forms with summary tables were made with EPPI®-Reviewer 4 software. For meta-analysis, Review Manager 5.4.1 was used to estimate pooled PPD risk factors with a 95% confidence interval (CI), forest plot, and a random-effect model. Cochran's (Q) test was employed to check for heterogeneity, while a funnel plot was utilised to investigate publication bias. RESULTS: The total included studies for this review were nine, with a combined sample size of 10,326 postnatal mothers. The identified risk factors were grouped into three clusters: biological, psychological, and social factors. A total of 42 risk factors for PPD were identified, with a history of depression and exposure to non-exclusive breastfeeding being the most significant predictors associated with increased risks of PPD in Malaysia. CONCLUSIONS: This systematic review and meta-analysis determined that biological determinants exerted the most influence on PPD among Malaysian women. This underscores the need of structured assessment in routine maternal care in the Malaysian context. Many studies in Malaysia used Edinburgh Postpartum Depression Scale postnatally, with less emphasis on antenatal period or follow-up studies, which highlights the need for a cultural-sensitive screening methods at routine maternal healthcare services in Malaysia. Patient or public contribution. No patient participated in any part of this systematic review, contributed to the discussion on refining the results, or critically reviewed the manuscript. Only academics were co-authors of this manuscript.