Social relationships and postpartum depression in South Asia: a systematic review

Background: Evidence suggests a much higher prevalence of postpartum depression in South Asia than in ‘western’ contexts. Aim: To conduct a rapid systematic review of evidence on the association between social relationships and postpartum depression in South Asia. Methods: Five databases were searched to identify relevant studies. Studies meeting the selection and quality criteria were analysed and integrated in a narrative review. Results: Nine mostly quantitative studies were included in the review. Low support and poor relationships with the husband and parents-in-law were associated with postpartum depression, although associations were weakened in multivariate analyses. The different dimensions of support have not yet been systematically investigated and the likely complex interrelationships between social relationship risk factors are not yet well understood. Conclusions: Findings mirror those from ‘western’ contexts, showing the key role of social relationships in the aetiology of postpartum depression. Yet, they also reinforce the hypothesis that the social and cultural context influences the association. The importance of relationships with the extended family, as well as the husband, in South Asia is highlighted. Further research is recommended to develop an understanding of these relationships to better inform interventions.