Nutritional factors and cross-national postpartum depression prevalence: an updated meta-analysis and meta-regression of 412 studies from 46 countries.
Level 3 - non-randomized controlled study
Systematic review and meta-regression of observational and ecological cross-sectional data
PubMed 37398595 · doi:10.3389/fpsyt.2023.1193490
What was done
The authors performed an updated systematic review and random-effects meta-analysis of studies assessing postpartum depression (PPD) prevalence via the Edinburgh Postnatal Depression Scale (combining a 2016–2021 search with a prior 1985–2015 dataset). Dietary consumption data (sugar-sweetened beverages [SSBs], fruit, vegetables, total fiber, yogurt, and seafood) were extracted from the Global Dietary Database. Random-effects meta-regression was conducted to evaluate whether between-country and within-country dietary differences predicted national PPD prevalence, controlling for economic and methodological factors.
What was found
The analysis included 412 studies covering 792,055 women across 46 countries. The global pooled PPD prevalence was 19.18% (95% CI: 18.02% to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Higher national SSB consumption was associated with higher PPD prevalence (Coefficient = 0.325, p = 0.044, 95% CI: 0.010 to 0.680). Within countries, years with higher SSB consumption also demonstrated higher PPD rates (Coefficient = 0.129, p = 0.026, 95% CI: 0.016 to 0.242). The abstract reported no statistical results for fruit, vegetable, fiber, yogurt, or seafood consumption.
Why it matters
This review provides an updated estimate that nearly one in five postpartum women globally experience depression. It also identifies population-level dietary sugar intake as an ecological correlate of cross-national variation in maternal mental health.
Limits
The dietary analysis relies on ecological, country-level aggregate data from the Global Dietary Database rather than individual-level intake, introducing risk of ecological fallacy. The observational design precludes causal inference, and the abstract omits numerical findings for several specified dietary factors.
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