Marriage and postpartum major depressive disorder: A systematic review and meta-analysis of cohort studies

Meng Wei; Yan Qin; Xingmeng Niu; Sifang Niu; Fuqin Mu; Lu Yang; Ying Li; Ying Zhang; JianLi Wang; Yan Liu

doi:10.1016/j.jpsychires.2025.01.004

Marriage and postpartum major depressive disorder: A systematic review and meta-analysis of cohort studies

J Psychiatr Res. 2025 Jan 7:182:83-91. doi: 10.1016/j.jpsychires.2025.01.004. Online ahead of print.

Authors

Meng Wei¹, Yan Qin², Xingmeng Niu³, Sifang Niu⁴, Fuqin Mu⁵, Lu Yang⁶, Ying Li⁷, Ying Zhang⁸, JianLi Wang⁹, Yan Liu¹⁰

Affiliations

¹ School of Public Health, Jining Medical University, Jining, 272013, China; School of Psychology, Shandong Normal University, Jinan, 250358, China.
² School of Public Health and Management, Shandong First Medical University, Jinan, 250117, China.
³ School of Public Health, Shandong Second Medical University, Weifang, 261053, China.
⁴ School of Public Health, Binzhou Medical University, Yantai, 264003, China.
⁵ School of Mental Health, Jining Medical University, Jining, 272013, China.
⁶ Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, B2N 5E3, Canada.
⁷ Library of Jining Medical University, Jining, 272067, China.
⁸ School of Public Health, China Studies Centre, University of Sydney, Sydney, NSW, 2006, Australia.
⁹ School of Public Health, Jining Medical University, Jining, 272013, China; Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, B2N 5E3, Canada. Electronic address: jianli.wang@dal.ca.
¹⁰ School of Public Health, Jining Medical University, Jining, 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining, 272013, China. Electronic address: hakunaly@163.com.

PMID: 39799667
DOI: 10.1016/j.jpsychires.2025.01.004

Abstract

Many studies have explored the relationships between demographic variables and postpartum major depressive disorder. However, there is no clear conclusion on the impact of different marital statuses and quality on postpartum major depressive disorder. This systematic review and meta-analysis examined the combined effects of different marital status and quality on postpartum major depressive disorder with cohort studies. Two authors independently searched 6 English databases (PubMed, Medline, Web of Science, PsycARTICLES, EBSCOhost and Scopus) and 3 Chinese databases (China Knowledge Resource Integrated Database (CNKI), Weipu database and Wanfang database) from the beginning of database construction to October 25, 2024. Studies that met the inclusion criteria included maternal diagnosis of postpartum major depressive disorder by clinical diagnostic criteria, inclusion of marital status, and reporting risk estimate. There were no language limitations in this study. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). Publication bias was assessed using a funnel plot and Egger's test. Finally, nineteen cohort studies were included in this meta-analysis. Low marital satisfaction was the most significant predictor of postpartum major depressive disorder (pooled RR = 3.47, 95% CI: 1.96, 6.12) followed by being single/divorced/separated/widowed/unmarried (pooled RR = 1.19, 95% CI: 1.02, 1.39). However, there was not a significant relationship between "worsening relationship/dissatisfaction with partner/problems in marital relationship" and postpartum major depressive disorder (pooled RR = 2.30, 95% CI:0.69, 7.62) yet. Marital status and marriage quality impacted heavily on maternal postpartum major depressive disorder. There is an urgent need to focus on family therapy and marital intervention for pregnant women and to enhance the sense of involvement of the husband or partner.

Publication types

Review