Environmental risk factors, protective factors, and biomarkers for postpartum depressive symptoms: an umbrella review

Jae Han Kim; Jong Yeob Kim; Seul Lee; San Lee; Brendon Stubbs; Ai Koyanagi; Elena Dragioti; Louis Jacob; Andre F Carvalho; Joaquim Radua; Trevor Thompson; Lee Smith; Hans Oh; Lin Yang; Michele Fornaro; Andrew Stickley; Gonzalo Salazar de Pablo; Kalthoum Tizaoui; Dong Keon Yon; Seung Won Lee; Jimin Hwang; Jae Il Shin; Paolo Fusar-Poli

doi:10.1016/j.neubiorev.2022.104761

Environmental risk factors, protective factors, and biomarkers for postpartum depressive symptoms: an umbrella review

Neurosci Biobehav Rev. 2022 Sep:140:104761. doi: 10.1016/j.neubiorev.2022.104761. Epub 2022 Jul 6.

Authors

Jae Han Kim¹, Jong Yeob Kim¹, Seul Lee¹, San Lee², Brendon Stubbs³, Ai Koyanagi⁴, Elena Dragioti⁵, Louis Jacob⁶, Andre F Carvalho⁷, Joaquim Radua⁸, Trevor Thompson⁹, Lee Smith¹⁰, Hans Oh¹¹, Lin Yang¹², Michele Fornaro¹³, Andrew Stickley¹⁴, Gonzalo Salazar de Pablo¹⁵, Kalthoum Tizaoui¹⁶, Dong Keon Yon¹⁷, Seung Won Lee¹⁸, Jimin Hwang¹⁹, Jae Il Shin²⁰, Paolo Fusar-Poli²¹

Affiliations

¹ Yonsei University College of Medicine, Seoul, the Republic of Korea.
² Department of Psychiatry, Yonsei University College of Medicine, Seoul, the Republic of Korea.
³ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.
⁴ Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain.
⁵ Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden.
⁶ Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
⁷ Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁸ Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Imaging of Mood, and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
⁹ Department of Psychology, University of Greenwich, London, UK.
¹⁰ The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.
¹¹ School of Social Work, University of Southern California, CA 90015, USA.
¹² Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
¹³ Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy.
¹⁴ Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
¹⁵ Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
¹⁶ Department of Basic Sciences, Medicine Faculty of Tunis, Tunis El Manar University, 15 Rue Djebel Lakdar, Tunis 1007, Tunisia.
¹⁷ Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, the Republic of Korea.
¹⁸ Department of Data Science, Sejong University College of Software Convergence, Seoul, the Republic of Korea.
¹⁹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
²⁰ Department of Pediatrics, Yonsei University College of Medicine, Seoul, the Republic of Korea. Electronic address: shinji@yuhs.ac.
²¹ Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; National Institute of Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.

PMID: 35803397
DOI: 10.1016/j.neubiorev.2022.104761

Abstract

We performed an umbrella review on environmental risk/protective factors and biomarkers for postpartum depressive symptoms to establish a hierarchy of evidence. We systematically searched PubMed, Embase, and the Cochrane Database of Systematic Reviews from inception until 12 January 2021. We included systematic reviews providing meta-analyses related to our research objectives. Methodological quality was assessed by AMSTAR 2, and the certainty of evidence was evaluated by GRADE. This review was registered in PROSPERO (CRD42021230784). We identified 30 articles, which included 45 environmental risk/protective factors (154,594 cases, 7,302,273 population) and 9 biomarkers (2018 cases, 16,757 population). The credibility of evidence was convincing (class I) for antenatal anxiety (OR 2.49, 1.91-3.25) and psychological violence (OR 1.93, 1.54-2.42); and highly suggestive (class II) for intimate partner violence experience (OR 2.86, 2.12-3.87), intimate partner violence during pregnancy (RR 2.81, 2.11-3.74), smoking during pregnancy (OR 2.39, 1.78-3.2), history of premenstrual syndrome (OR 2.2, 1.81-2.68), any type of violence experience (OR 2.04, 1.72-2.41), primiparity compared to multiparity (RR 1.76, 1.59-1.96), and unintended pregnancy (OR 1.53, 1.35-1.75).

Keywords: Biomarkers; Environmental risk and protective factors; Postpartum depressive symptoms; Umbrella review.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Depression*
Female
Humans
Postpartum Period*
Pregnancy
Protective Factors
Risk Factors
Systematic Reviews as Topic

Substances

Biomarkers

Grants and funding

301206/DH_/Department of Health/United Kingdom