Postnatal Depression: An Underestimated Humanistic Burden in Maternal Health

OBJECTIVES: Postnatal depression (PND) affects up to 20% of women within 6 weeks postpartum. The lack of medical support for primiparous and multiparous women with PND results in compromised maternal brain response and behaviour resulting in a reduced quality of life (QOL). A 2018 systematic literature review on the humanistic burden of PND provided limited evidence on women in Europe, as most studies focused on fathers, children, or non-European regions. Consequently, we conducted a targeted literature review to examine the evolution of humanistic burden of PND in adult women in the US, UK, and Europe.

METHODS: The searches were conducted on Embase (January 2018-May 2024) and ISPOR presentations database to identify publications assessing the burden of illness of PND. The key terms included ‘peripartum/postnatal/postpartum depression’, ‘burden of illness/disease’, ‘patient outcome’, ‘medical outcomes survey’, and ‘quality of life’.

RESULTS: The literature search identified 3,375 articles, which were screened. Identified studies, including clinical trials and observational studies, were predominantly conducted in the US and Europe. Both disease-specific tools (e.g., Edinburgh Postpartum Depression Scale) and generic instruments (e.g., General Information Questionnaire, General Well-Being Scale, and Short-Form 12 Health Survey Version 2) were used to assess QOL of women with PND. Overall, despite the low number of included studies, all show that PND is associated with a decline in maternal QOL due to various factors, regardless of the tools and instruments used.

CONCLUSIONS: Building on prior research, this study reaffirmed that women with PND experience a substantial humanistic burden mainly attributed to their mental health. The paucity of PND burden of illness studies conducted in the US, UK, and Europe underscores the necessity for additional longitudinal investigations to delineate risk factors, enhance treatment strategies, and develop first-in-class treatments.