Prevalence and Risk Factors for Depression among Parents of Children Born Preterm: A Systematic Review and Meta-analysis of The Evidence Since 2000

Megan A. M. Moorhouse; Piranavi Jeyagaran; George N. Okoli; James M. Bolton; Nicole Askin; Kristene Cheung; Lisa M. Lix; Allan Garland; Deepak Louis

doi:10.1055/a-2568-1653

American Journal of Perinatology, Table of Contents

Am J Perinatol
DOI: 10.1055/a-2568-1653

Original Article

Prevalence and Risk Factors for Depression among Parents of Children Born Preterm: A Systematic Review and Meta-analysis of The Evidence Since 2000

Megan A. M. Moorhouse

¹Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

,

Piranavi Jeyagaran

²Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada

,

George N. Okoli

³George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

⁴College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

⁵Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Canada

,

James M. Bolton

⁶Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

,

Nicole Askin

⁷WRHA Virtual Library, University of Manitoba, Winnipeg, Canada

,

Kristene Cheung

⁸Department of Clinical Health Psychology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

,

Lisa M. Lix

⁹Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

¹⁰Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada

,

Allan Garland

¹⁰Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada

¹¹Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

,

Deepak Louis

¹²Department of Pediatrics and Child Health, Section of Neonatology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

› Author Affiliations

Abstract

Objective

Previous reviews of depression among parents of preterm children were restricted to mothers within the first year of preterm delivery. We aimed to systematically review the prevalence and risk factors for depressive symptoms among mothers and fathers in the first 5 years following preterm birth.

Study Design

This systematic review was undertaken following the Cochrane Handbook for Systematic Reviews of Interventions Guidelines and reported using the preferred reporting items for systematic reviews and meta-analysis guidelines. Peer-reviewed, all-language, observational studies from the year 2000 that assessed the prevalence and/or risk factors for depression among parents of children born preterm (<37 weeks gestation) in the first 5 years following preterm birth, using validated clinical scales, were included. Medline, Embase, Web of Science Core Collection, CINAHL, PsycINFO, and Cochrane Central were searched on July 29, 2021. The NIH quality assessment tool was used. Meta-analysis was performed using inverse variance effects models to estimate prevalence and identify risk factors.

Results

Seventy-eight studies were included. The majority were English language (n = 71), European (n = 32), and cross-sectional studies (n = 44), using the EPDS scale (n = 45). The prevalence of depressive symptoms among mothers was 25% (95% confidence interval (CI): 21–31%; n = 72) in the first year, and 20% (13–30%; n = 8) in the second to fifth year, while for fathers, the rates were 13% (8–22%; n = 15) and 11% (2–50%; n = 1), respectively. Eastern Mediterranean region had the highest prevalence of maternal depressive symptoms in the first year (48% [25–72%; n = 3]), while it was the Western Pacific region for fathers (17% [15–19%]). Low educational status (odds ratio: 3.5; [95% CI: 1.9–6.5; n = 2]) was associated with depressive symptoms among mothers in the first year.

Conclusion

Mothers and fathers had a high prevalence of depressive symptoms in the first 5 years following preterm birth, with region variations in the prevalence (PROSPERO registration no.: CRD42021260748).

Key Points

What is known: mothers are at increased risk of depression in the first year.
What this study adds: Parents are at increased risk in the first 5 years.
How this study might affect policy: equitable allocation of resources in the health system.
How this study might affect practice: increase screening among parents of premature infants.
How this study might affect research: inform the need to collect risk-specific data.

Keywords

prematurity - depression - mothers - fathers

Full Text

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