Abstract

Postpartum depression (PPD) is a significant mental health concern affecting mothers worldwide, with varying prevalence rates influenced by sociocultural and economic factors. In Saudi Arabia, studies report widely divergent PPD rates, necessitating a systematic synthesis of existing evidence. This systematic review aimed to determine the prevalence of PPD in Saudi Arabia and identify key risk and protective factors. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted. Twenty-two observational studies (cross-sectional, case-control, and retrospective) assessing PPD prevalence and associated factors in Saudi mothers within 1 year postpartum were included. Data were extracted on study characteristics, PPD prevalence (assessed via Edinburgh Postnatal Depression Scale (EPDS) or clinical diagnosis), and risk/protective factors. Risk of bias was evaluated using the Newcastle-Ottawa Scale. PPD prevalence ranged from 5.1% to 75.7%, with heterogeneity attributed to regional and methodological differences. Key risk factors included lack of social/spousal support (reported in 10 studies), history of depression (8 studies), cesarean delivery (6 studies), and financial stress. Breastfeeding and higher income emerged as protective factors. Most studies (15/22) had a moderate risk of bias due to convenience sampling and unadjusted confounders. PPD is highly prevalent in Saudi Arabia, with risk factors rooted in biological, psychological, and sociocultural contexts. Findings underscore the need for targeted interventions, including enhanced social support systems, routine screening, and culturally sensitive mental health policies.

Key words: Postpartum depression, Saudi Arabia, prevalence, risk factors, maternal mental health