The results of a systematic literature review and meta-analysis suggest a correlation between fatigue and depressive symptoms in women in the 2 years following childbirth. The results were published in the Journal of Affective Disorders.
Investigators searched for published and grey literature studies on fatigue and depression in postpartum parents. To be selected for inclusion, studies had to be published in English between 1990 and December 20, 2017, report depression and fatigue using scaled measures, and provide data on any observed correlation between the two. Abstract and full-text screening was conducted independently by 2 raters who extracted data in the form of demographic information, measurement factors, correlation coefficients, and chi-square associations. Study quality was evaluated per the principles of the Strengthening the Reporting of Observational Studies in Epidemiology Statement. Separate regression analyses were performed to assess the correlation between fatigue and depression across studies.
A total of 310 eligible papers were identified, of which 35 met the inclusion criteria. Most studies were observational (86%), and all but 1 reported data for mothers only. The majority of papers (74%) recruited parents from Western nations, and 40% recruited from the United States specifically. The random effects model indicated a strong positive correlation between fatigue and depressive symptoms in women in the postpartum period (r = 0.52; 95% CI, 0.45-0.59; P <.001). The fatigue-depression correlation was positive for all studies and ranged from r = 0.24 to r = 0.81.
When discussing limitations, investigators noted that fatigue was measured inconsistently across studies, with 21 different self-report scales utilized. In addition, while most papers used validated fatigue scales, 4 papers (11%) reported use of a scale with unknown psychometric properties. Just 49% of papers specified how missing data and attrition were addressed in their analyses. Finally, heterogeneity was high between studies, (P <.001), and was not accounted for by demographic information or study methodology.
After completing the review, investigators suggested future studies could more fully explore the relationship between fatigue and depression by looking at women’s partners, measuring symptomology beyond 6 months postpartum, and diversifying population by including parents from non-Western countries and from more diverse socio-economic backgrounds. Addressing the heterogeneity and standardizing the use of fatigue scales could also be beneficial.
Wilson N, Lee JJ, Bei B. Postpartum fatigue and depression: A systematic review and meta-analysis. J Affect Disord. 2018;246:224-233.