title: A systematic review and meta-analysis of the association between unintended pregnancy and perinatal depression.
abstract: BACKGROUND
  There is a growing interest in exploring maternal mental health effects of unintended pregnancies carried to term. However, the evidence base from a small number of available studies is characterised by considerable variability, inconsistency and inconclusive findings. We present a systematic review and meta-analysis of all available studies on unintended pregnancy as these are related to maternal depression.
  
  
  METHODS
  Using PRISMA guideline, we systematically reviewed and meta-analysed studies reporting an association between unintended pregnancy and maternal depression from PubMed, EMBASE, PsychINFO and Google Scholar. We used a priori set criteria and included details of quality and magnitude of effect sizes. Sample sizes, adjusted odds ratios and standard errors were extracted. Random effects were used to calculate pooled estimates in Stata 13. Cochran's Q, I(2) and meta-bias statistics assessed heterogeneity and publication bias of included studies.
  
  
  RESULTS
  Meta-bias and funnel plot of inverse variance detected no publication bias. Overall prevalence of maternal depression in unintended pregnancy was 21%. Unintended pregnancy was significantly associated with maternal depression. Despite statistically significant heterogeneities of included studies, sub-group analyses revealed positive and significant associations by types of unintended pregnancies, timing of measurements with respect to pregnancy and childbirth, study designs and settings.
  
  
  CONCLUSIONS
  The prevalence of perinatal depression is two-fold in women with unintended pregnancy. Perinatal care settings may screen pregnancy intention and depression of women backed by integrating family planning and mental health services.
authors.affiliation: School of Public Health, The University of Queensland, Australia. Electronic address: amanuel.abajobir@uqconnect.edu.au.
authors.forename: Amanuel Alemu
authors.initials: AA
authors.lastname: Abajobir
authors.affiliation: School of Public Health, The University of Queensland, Australia.
authors.forename: Joemer Calderon
authors.initials: JC
authors.lastname: Maravilla
authors.affiliation: School of Public Health, The University of Queensland, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, Australia.
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
authors.affiliation: School of Public Health, The University of Queensland, Australia; School of Social Sciences, The University of Queensland, Australia.
authors.forename: Jackob Moses
authors.initials: JM
authors.lastname: Najman
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008605:Mental Health Services; D016017:Odds Ratio; D018743:Perinatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D049168:Pregnancy, Unplanned / Q000523:psychology*; D015995:Prevalence
keywords: Childbirth; Depression; Maternal mental health disorders; Unintended or unplanned pregnancy