Migration and perinatal mental health in women from low- and middle-income countries: a systematic review and meta-analysis.
BACKGROUND
Migrant women are at risk of perinatal mental disorders due to stressors experienced before, during and after migration.


OBJECTIVE
This systematic review and meta-analysis summarises the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC).


METHODS
We systematically searched nine electronic databases and the grey literature using a predefined search strategy.


METHODS
Studies were included if they assessed pregnant or postpartum migrants from LMIC, used a structured tool and a case-control, cross-sectional, cohort or intervention study design.


METHODS
Data was double-extracted. We calculated pooled prevalence of depression and weighted mean anxiety and depression scores. We calculated crude odds ratios from risk factor studies and summarised intervention studies descriptively.


RESULTS
Forty studies were identified from 10 123 references. Pooled prevalence was 31% [95% condidence interval (CI) 23%-40%] for any depressive disorder and 17% (95% CI 12-23%) for major depressive disorder. Previous depression and lower social support were associated with perinatal depression. There were insufficient data to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population.


CONCLUSIONS
One in three migrant women from LMIC experiences symptoms of perinatal depression. Social support is an important protective factor. Evidence on LMIC women relocating to other LMIC is lacking. Given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority.


CONCLUSIONS
One in three migrant women from low- and middle-income countries has symptoms of perinatal depression.
Nuffield Department of Population Health, University of Oxford, Oxford, UK.
G
G
Fellmeth
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
M
M
Fazel
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
E
E
Plugge
D003906:Developing Countries; D005260:Female; D006801:Humans; D000068097:Maternal Health / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008603:Mental Health / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011203:Poverty; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D014171:Transients and Migrants / Q000523:psychology*
Low- and middle-income countries; mental health; migration; postpartum; pregnancy; refugee