Literature review for - Flourish Paediatrics

Many epidemiological studies have documented the prevalence of postnatal depression
around the world (O'Hara 2009). The prevalence rate is generally estimated to be in the range
10-15% although there is considerable variation reported between countries (Grote, Vik et al.
2010). In developing countries is often reported as higher and the literature contains
prevalence of 16% to 35% (Ghubash, AbouSaleh et al. 1997; Cooper, Tomlinson et al. 1999;
Patel, Rodrigues et al. 2002). The lowest rates have been reported from Singapore, Malta,
Denmark and Malaysia (0.5-9%) with higher rates in Guyana, Costa Rica, Italy, Chile,
Taiwan, and Pakistan (34- 63.3%) (Halbreich and Karkun 2006; Klainin and Arthur 2009)
However, many of these studies used small and inadequate samples. A review of 59 studies
found that the mean prevalence of postpartum cases was 13% with onset mostly within the
first three months postpartum (O'Hara and Swain 1996). More recent studies have found that
7% of women experienced a major depressive episode within three months of delivery
(Gavin, Gaynes et al. 2005) and when cases of minor depression were included, the 3-month
period prevalence rate increased to 19 % (Gavin, Gaynes et al. 2005).
POSTNATAL DEPRESSION AND INFANT FEEDING OUTCOMES
What is the association between postnatal depression and shorter breastfeeding duration?
Draft Evidence statement
Draft Grade
Component Rating Notes
Postnatal depression is associated with a shorter
breastfeeding duration
Evidence Base Good 1 SLR [1P] of 49 studies
C
Consistency Good 12 studies in the SLR reported that mothers with
depressive symptoms were significantly more likely to
discontinue breastfeeding earlier than non-depressed
mothers.
Clinical impact Satisfactory Moderate
Generalisability Good The SLR consist of studies from a variety of
developed and developing countries including
Australia.
Applicability Good Results are applicable to Australian women
The studies included in the body of evidence statement are shown in the Table below
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