Publication:

Postpartum depression: a scoping review of epidemiology, determinants, pathophysiological mechanisms and management

Postpartum depression (PPD) is a common maternal mental health problem with significant consequences for mothers, infants, and families. Despite growing research, evidence remains fragmented across different domains, limiting a comprehensive understanding. This scoping review aimed to map and synthesize the existing literature on the epidemiology, determinants, pathophysiological mechanisms, and prevention and management strategies of postpartum depression. A scoping review was conducted following the framework proposed by Arksey and O’Malley and reported in accordance with PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, and Google Scholar was performed for studies published between 2000 and 2025. Studies addressing postpartum depression in terms of prevalence, risk factors, biological mechanisms, and interventions were included. Data were extracted and synthesized thematically. A total of 33 studies were included in the review. The global prevalence of postpartum depression was estimated at approximately 17%, with higher rates observed in low- and middle-income countries. Key determinants included antenatal depression, psychosocial stressors, lack of social support, and obstetric complications. Pathophysiological mechanisms involved hormonal withdrawal, hypothalamic-pituitary-adrenal axis dysregulation, neurochemical alterations, and inflammatory processes. Prevention strategies focused on early screening, psychosocial interventions, and the management of modifiable risk factors. Management approaches included psychological therapies, pharmacological treatment, and emerging therapies such as neurosteroid-based interventions. Postpartum depression is a complex condition that needs integrated, multidisciplinary strategies for effective prevention and management. Enhancing early screening, increasing access to mental health services, and implementing tailored, context-specific interventions are crucial to lowering the global burden of postpartum depression.