Research AppraisalSystematic Review

Prevalence of perinatal depression in Ethiopia: An umbrella review of systematic review and meta-analysis studies

PloS oneNecho, Mogesie, Shegaw, Maregu, Anbesaw, Tamirat et al.DOI

Clinical Snapshot

85CEBM
Evidence: ModerateSystematic Review

PICO Framework

P — PopulationWomen during pregnancy and postpartum period in Ethiopia
I — InterventionNot applicable (prevalence study)
C — ComparatorNot applicable (prevalence study)
O — OutcomesPrevalence of perinatal depression (antenatal and postnatal depressive symptoms)

Bottom Line

This umbrella review synthesises evidence from 8 systematic reviews encompassing 28 unique primary studies and 15,592 Ethiopian women, finding a pooled perinatal depression prevalence of 22.49%. The prevalence was similar between antenatal (22.76%) and postnatal (21.75%) periods. While the study employed appropriate methodology including PROSPERO registration and AMSTAR quality assessment, significant concerns exist regarding the very high overlap (25.5%) between primary studies across included reviews, potentially inflating precision estimates. The prevalence rates are substantially higher than those typically reported in high-income countries, highlighting the significant burden of perinatal mental health issues in low-resource settings. For Australian clinicians, these findings may be relevant when caring for Ethiopian immigrant populations, though direct applicability is limited due to contextual differences. The results underscore the global importance of perinatal mental health screening and intervention programs, particularly in resource-constrained settings.

Evidence: Moderate

Key Findings

  • P Value: Not reported

  • Effect Size: 22.49% overall prevalence

  • Primary Outcome: Pooled prevalence of perinatal depressive symptoms

  • Nnt Or Sensitivity: Antenatal: 22.76% (95% CI: 19.9-25.62%), Postnatal: 21.75% (95% CI: 21.03-22.48%)

  • Confidence Interval: 95% CI: 21.38-23.59%

Clinical Application

Results provide baseline prevalence data for healthcare planning and resource allocation Limited direct applicability to Australian practice due to different healthcare systems, cultural contexts, and socioeconomic factors. May inform care for Ethiopian immigrant populations in Australia Ethiopian women during pregnancy and postpartum period

Abstract

BACKGROUND: Perinatal depression is a significant public health concern that affects women during pregnancy and the postpartum period. Despite being acknowledged globally, the burden of perinatal depression is particularly profound in low and middle-income countries, such as Ethiopia. This umbrella review is therefore intended to systematically consolidate findings on perinatal depression among Ethiopian women to better understand its prevalence, thereby highlighting the gaps in current research and informing future interventions. METHODS: This umbrella review used the PRIOR checklist for the reviews of systematic review and meta-analytic studies. The review protocol has been registered on PROSPERO: CRD42023495174. PubMed, EMBASE, and PsycINFO databases were searched for the presence of systematic review and meta-analysis studies. The quality of included articles has been evaluated with a measurement tool to assess systematic review and meta-analysis studies (AMSTAR). A novel graphic approach with an estimated corrected covered area (CCA) has been used to determine the degree of overlap of primary studies in the systematic review and meta-analysis studies. The weighted random effect model was used during the meta-analysis. RESULT: A total of 28 unique primary studies and 8 systematic reviews, and meta-analysis studies with 15,592 participants were included in this umbrella review. The pooled prevalence of perinatal depressive symptoms in the included systematic review and meta-analysis studies ranges from 20.1% to 25.8%. The pooled umbrella prevalence of perinatal depressive symptoms among women in Ethiopia was 22.49% (95 CI%:21.38, 23.59). The pooled umbrella analysis revealed that the antenatal and postnatal depressive symptoms were 22.76% (95% CI: 19.9, 25.62) and 21.75% (95% CI: 21.03, 22.48), respectively. In addition, the pooled prevalence of perinatal depression in studies that included 10 or below primary studies is 22.86% (95%CI:20.39, 25.33), and in those that included below 10 primary studies, it was 22.10% (95%CI: 21.55, 22.65). The novel graphic presentation depicted a very high degree of overlap of primary studies in the included systematic reviews and meta-analysis studies; corrected covered area (CCA) of 25.5%. Four of the included studies (fifty percent) had high methodological quality, and the remaining four relied on a moderate quality range. CONCLUSION: The pooled overall, antenatal, and postnatal prevalence of depression symptoms was high in Ethiopia, with no significant difference during the antenatal and postnatal period. An improved understanding of perinatal depression will therefore guide policymakers and health practitioners in developing targeted strategies to alleviate this mental health challenge.

References

  1. 1.Necho, M., Shegaw, M., Anbesaw, T., Birru, N., Ayano, G., Tsehay, M., Getnet, W., Yimer, S., Belete, A., Zenebe, Y., Birhan, Z., & Tiruneh, C. (2026). Prevalence of perinatal depression in Ethiopia: An umbrella review of systematic review and meta-analysis studies. PLoS One. https://doi.org/10.1371/journal.pone.0347570
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