Association between hypertensive disorders of pregnancy and postpartum depression: a study on low-and middle-income countries with insights from Ghanaian healthcare professionals

Hypertensive disorders of pregnancy (HDP) and postpartum depression (PPD) are significant global healthchallenges affecting maternal and child well-being. HDP, including pre-eclampsia, gestational hypertension, andchronic hypertension, complicate up to 10% of pregnancies worldwide, with profound implications for maternalmortality, particularly in low- to middle-income countries (LMICs) like Ghana. The incidence of HDP is risingglobally, contributing substantially to maternal deaths and severe perinatal outcomes such as stillbirth and low birth weight. Concurrently, perinatal mental health issues, including PPD, affect a significant proportion ofwomen globally, with higher prevalence rates observed in LMICs. Despite the known physiological impacts ofHDP, their association with maternal mental health remains underexplored, especially in LMIC contexts. Asystematic review and meta-analysis were conducted to explore the association between HDP and PPD inLMICs, focusing on available literature and studies from diverse global settings. Additionally, semi-structuredqualitative interviews were conducted with healthcare professionals in Ghana to gather insights into localperspectives and experiences regarding this association. The systematic review revealed a consistent associationbetween HDP and increased risk of PPD across various LMIC settings. Meta-analysis findings indicated asignificant pooled odds ratio, highlighting a robust statistical linkage between HDP severity and subsequent PPDrisk. Qualitative data underscored healthcare professionals' observations of heightened psychological distressamong women with HDP, emphasizing the complex interplay between physiological complications and maternalmental health outcomes in the Ghanaian context. The study findings underscore the critical need for integratedmaternal health strategies that address both physical and psychological aspects of pregnancy complications likeHDP. By elucidating these connections, the study contributes to advancing evidence-based interventions ...