Published online Oct 16, 2025. doi: 10.12998/wjcc.v13.i29.110948
Revised: June 30, 2025
Accepted: July 24, 2025
Published online: October 16, 2025
Processing time: 70 Days and 19.4 Hours
Postpartum depression (PPD) is a prevalent and debilitating psychiatric disorder affecting maternal mental health, infant development, and family well-being. Despite increasing global awareness, significant disparities remain in screening, diagnosis, and treatment, particularly in low-resource and culturally diverse settings. The complex interplay of biological and psychosocial determinants complicates conventional intervention models. Integrating epidemiological patterns, pathophysiological mechanisms, and sociocultural factors will inform more effective and equitable strategies for PPD screening, prevention, and treatment.
To synthesize current evidence on risk factors, underlying mechanisms, and interventions for postpartum depression and outline directions toward equitable care.
A narrative review was conducted following PRISMA 2020 guidelines. Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed, Web of Science, EMBASE, and PsycINFO. Inclusion criteria comprised studies addressing PPD epidemiology, risk stratification, biological mechanisms, and intervention strategies. After screening and full-text review, 84 studies were included. Study designs primarily involved cohort studies, randomized controlled trials, and meta-analyses. Extracted data were categorized thematically and assessed for methodological quality and generalizability.
PPD arises from multifactorial interactions involving hormonal dysregulation, neurochemical changes, psychosocial stressors, and cultural influences. Primary risk factors include personal or family history of depression, antenatal anxiety, low maternal self-efficacy, and inadequate social support. Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening, cognitive behavioral therapy, interpersonal psychotherapy, psychoeducation, and pharmacological treatments such as brexanolone and zuranolone. Culturally adapted, community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability, particularly in underserved populations. Emerging evidence highlights inflammatory biomarkers (e.g., interleukin-6 and C-reactive protein), AI-assisted screening tools, and family-inclusive strategies as promising for enhanced detection and outcomes.
Effective PPD management requires integrative, culturally sensitive approaches, prioritizing scalable, personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.
Core Tip: This systematic review synthesizes recent evidence on postpartum depression, highlighting its multifactorial etiology involving hormonal, inflammatory, and psychosocial mechanisms. It evaluates emerging interventions including cognitive behavioral therapy, community-based models, and GABAergic modulation. The review proposes a stepped-care framework integrating biological risk stratification, culturally adapted tools, and digital delivery platforms, aiming to advance equitable and personalized maternal mental health care globally.