Postpartum Mental Health and Its Relationship with Mediating Social Determinants of Health in Iran based on the WHO Model: A Systematic Review

Background: Pregnancy is a complex and vulnerable period that causes some challenges including the development of postpartum psychiatric disorders (PPDs) for women. Identifying the factors associated with these disorders can be effective in reducing maternal symptoms and supporting mother, child and family. The aim of this study was to identify the relationship between postpartum mental health and mediating social determinants of health in Iran. Methods: In this systematic review, the Persian and English observational studies in Iran were obtained through advanced search in online databases, such as PubMed, Scopus, EMBASE, SID, Magiran, Psycinfo, and Google Scholar search engine in the period of January ۲۰۰۵ to August ۵, ۲۰۲۱ using the following keywords: social determinants, mediating factors, social support, mental health, risk factors, postpartum, Iran, and their English equivalents through Mesh. Articles were selected based on the inclusion and exclusion criteria and quality assessment of articles was performed using the standard Newcastle-Ottawa Scale (NOS). Results: Out of ۴۲ eligible articles (total sample: ۳۹۲۱۶), ۴۰ articles examined the relationship between postpartum depression and ۲ articles studied the relationship of maternal grief with some mediating social determinants. In general, these factors were classified into five categories, including midwifery and pregnancy-related factors, psychosocial conditions, factors related to postpartum status, behavioral factors and material status or conditions, and health care. Conclusion: Mothers' mental health is affected by many underlying factors; Therefore, identifying the risk factors associated with mental disorders in this population based on the model of the WHO (World Health Organization), especially in the mediating area (Material and environmental conditions, Psychosocial, Behavioral factors, Health system) due to the extent of this area is very important.

Keywords:

Iran , Mental health , Postpartum , Social determinants of health , intermediate factors