Table 1.

Characteristics of selected studies.

Author(s)	Aims	Sample population	Main findings	Conclusion	Limitations
Morhason-Bello et al. (2009)	Assess the effect of psychosocial support on labour outcomes.	585 recruited from the University College Hospital Ibadan.	Control 5 times likely to deliver by caesarean section (95% CI 1.98–12.05), higher pain scores (p = 0.0011).	Women with companionship had better labour outcomes compared to those without.	The response could suggest perceptions of quality of care, health workers’ attitude, ward environment.
			Experimental satisfying labour (OR = 3.3 95% CI = 2.15–5.04).
Gureje et al. (2019)	Compare high-intensity treatment (HIT) with low-intensity treatment (LIT).	686 pregnant women who were registering for antenatal care were recruited.	HIT was effective for severe depression (OR = 2.29; 95% CI = 0.73, 1.01, 5.20; p = 0.047, higher exclusive breastfeeding.	Except for severely depressed perinatal women, no evidence to recommend HIT over LIT.	Enhanced care-as-usual was offered, rather than routine care as usual.
			Infant outcomes were similar across both interventions.
Chinawa et al. (2016)	Prevalence of postnatal depression in Enugu.	Mothers attending postpartum clinics, 214 participants.	The prevalence of postpartum depression was 22.9%.	Prevalence in Enugu is comparable to African continents.	Not conducted in the community, a selection bias may be present.
Uwakwe (2003)	EPDS validity on Nigerian women.	225 women, Nnamdi Azikiwe University Teaching Hospital.	24 (10.7%) subjects had depression. An optimal cut-off score of 9, the EPDS had a sensitivity of 0.75 and specificity of 0.97.	EPDS distinguished depressed (t = 7.63, p < 0.001, df = 222).	Single site study.
Ndukuba et al. (2015)	Characteristics of those postpartum conditions.	76 women with postpartum psychiatric conditions.	Schizophrenia was commonest 48.7% 37/76, depression 22% 17/76 and mania 15% 11/76.	Encourage services into rural areas for early detection.	Referral bias.
Findley et al. (2013)	Results of maternal and child health programme.	2009 (n = 2129)–2011 (n = 2310) women with births in 5 years.	Anti-tetanus vaccination rates increased 69.0% to 85.0%.	The intervention was effective at changing infant care outcomes.	The assumption is under-reporting; a study push may present higher rates.
			Infant and child mortality declined greater in the intervention.
Oyelohunnu et al. (2016)	Distress, mothers and child interaction.	98 women recruited from child immunisation clinic in Lagos.	An association was found between reduced maternal-child attachment interaction and maternal depression (p < 0.05).	Emotional disorders risk for reduced maternal-child interaction.	The design limits result in being generalised for causation.
Adewuya et al. (2008)	Postnatal depression on infant’ physical growth.	120 depressed and 122 non-depressed postpartum women.	Infants of depressed mothers’ significant poorer growth than non-depressed, and likely more episodes of diarrhoea.	Preventative methods of postnatal depression.	The study did not account for depression during pregnancy.
Ukpong et al. (2003)	Depression and preterm and full-term infants.	60 postnatal women, 33 preterm neonates, 27 full terms.	Mothers of preterm neonates (27.3%) statistically more depressed than mothers of full-term normal infants (3.7%).	These psychological difficulties are not usually detected.	93.9% preterm babies had various complications, impact wellbeing.
Sulyman et al. (2016)	The prevalence rate of postnatal depression, risk factors in Nigeria.	483 participants who delivered at a tertiary health institution.	Prevalence rate 22.4%. Risk factors unemployment (OR [OR] = 0.49, 95% CI = 0.27–0.86, p = 0.018), lack of support from husband (OR = 0.34, 95% CI = 0.19–0.60, p = 0.000).	The prevalence of postnatal depression was high and negatively impacts parent skills.	Single centred recruitment.
Onyemaechi et al. (2017)	Self-esteem, social support and age on postpartum depression.	116 mothers recruited from 5 hospitals presenting for postpartum check-ups.	Participants with low self-esteem had higher scores (F = 14.097, p < 0.0001). Subjects with low social support experienced higher rates of depression (F = 4.368, p < 0.05).	Social connection is an essential factor for mothers.	The sample size was moderate.
Adewuya et al. (2007)	Prevalence of the depressive disorder in late pregnancy.	180 women in late pregnancy (32 weeks and above) recruited from antenatal clinics.	Risk factors single (OR = 16.67, 95% CI = 3.17–87.76), divorces/separated (OR = 11.11, 95% CI = 1.55–19.65), polygamous (OR = 3.92, 95% CI = 0.94–16.66), lack of social support (OR = 6.08, 95% CI = 1.42–26.04).	Depression is common in late pregnancy in Nigerian women. Significant predictors are mainly social and family factors.	The sample size was moderate.
Thompson and Ajayi (2016)	Prevalence of antenatal depression and risk factors, in Nigeria.	314 women attending antenatal clinics.	The prevalence rate was 24.5% for antenatal depression.	Antenatal depression is prevalent in Nigerian women. Interventions will need to address risk factors.	The sample was screened for probable depression; no case of depression could be confirmed.
			Risk factors marital status (p = 0.010), gender-based abuse (p = 0.034), history of previous caesarean section (p = 0.032).
Ayinde et al. (2018)	Quality of care received by women.	20 facility managers, 218 women recruited.	The perinatal women rated the service as good quality (96%) and satisfied with the care received (98%).	Major inadequacies in the maternal care facilities.	Limited awareness of quality care indicated by low service expectation.
Owoeye et al. (2006)	EPDS scores in a group of Nigerian women.	252 women were recruited from a 68-bed maternity hospital.	23% scores 12 and above on the EPDS. Risk factors marital conflict, rejected paternity of the new-born baby, (OR = 9.44, CI = 2.35–37.82) single status (OR = 5.76, CI = 1.96–16.94).	Postpartum depression is a major complication during childbirth in Nigeria.	The hospital-based study may not reflect the wider community.
Adewuya (2005)	Maternity blues in Nigerian postpartum women.	502 completed the screening questionnaires, giving a response rate was 86.3%.	Prevalence was 31.3%, symptoms peaked on the fifth day.	Differentiations across cultures for maternity blues must be considered in strategies for prevention.	There was a high rate of exclusion and drop out in the study.
			Significant predictors female baby (OR = 2.82, 95% CI = 1.53–4.12), and single mothers (OR = 3.35, 95% CI = 2.26–5.64).
Adeponle et al. (2017)	How culture shapes social determinants and depression.	14 mothers with perinatal depression, 14 family caregivers, 11 health carers.	Perinatal depression associated with sociomoral concerns over gender roles. Risk factors, having a female child, ‘spiritual attack’ and not resting sufficiently after childbirth.	Assessments and interventions to consider local social contexts and meanings of depression.	Possible selection bias as women recruited only from hospitals, health centres, faith and traditional centres.
Bakare et al. (2014)	National Programme on Immunisation in southeast Nigeria	408 mothers recruited from 2 main University teaching hospitals in Enugu State.	15.2% met a diagnosis for depression.	The programme may provide evidence to support the early screening of mothers for depression in Nigeria.	The growth parameters of the infants were only studied once, and therefore no follow-up.
			Postnatal depression significantly associated with the growth of weight and length of infants, but not head circumference.
Adewuya et al. (2006)	Anxiety disorders in late pregnancy.	181 women in late pregnancy (32 weeks and above).	The rate of anxiety disorder in pregnant was 39.0% compared with 16.3% in the non-pregnant (p < 0.001).	The rate of social anxiety was higher in pregnant than non-pregnant.	The onset of the disorder was not taken into account.
Agbaje et al. (2019)	Depression, anxiety.	270 postpartum women.	34.6% postpartum depression, 33.3% anxiety symptoms.	High prevalence in Nigerian women.	Considers one type of care service.
Ishola et al. (2018)	Postpartum depression among mothers of preterm babies in Lagos.	152 mothers recruited from the Massey Street Children’s Hospital.	Reliability (α) of 0.91, validity exploratory factor analysis cognitive, emotional difficulty (α = 0.92), hopelessness, suicidal ideation (α = 0.93), distress (α = 0.71).	Screening tool valid and easy to administer for postnatal depression mothers of preterm babies.	The study did not compare with women with full-term babies to ascertain its discriminant validity.
Ukpong (2011)	Psychological morbidity in mothers of preterm infants.	57 mothers of preterm infants were recruited.	36.8% high levels of psychological distress, 19.3% depression, 12.3% of cases were of anxiety. Psychological morbidity and depression related to neonatal birth weight.	Detection and management of postnatal psychological morbidity should be a priority in Nigeria.	The sample size was small, and the study was not longitudinal.
Loto et al. (2010)	Mode of delivery, self-esteem and parenting self-efficacy.	115 women had a caesarean section. 97 matched control of mothers had a vaginal delivery.	Self-esteem was lower for caesarean section (p = 0.006 and at 6 weeks (p < 0.001). Parent-child relationship scores lower caesarean (p < 0.001, OR = 4.71, 95% CI = 1.75–14.71).	Nigerian women who deliver via caesarean; low self-esteem, poor parenting self-efficacy in postnatal.	It did not account for mothers who had low self-esteem before delivery.
Odinka et al. (2018)	Postpartum anxiety and marital satisfaction.	309 nursing mothers were recruited.	Postpartum anxiety 31.1%, 33.3% depression. Co-morbid depression, anxiety (22%), high marital dissatisfaction.	Association marital dissatisfaction and depression and anxiety.	The design of the study limits the ability to draw causal conclusions.
Adefuye et al. (2008)	Postpartum mental disorders.	January 1988 and December 2007 were 9085 deliveries.	There were 27 cases of puerperal mental illness, which gave an incident rate of 2.9 per 1000 births.	The high incident rates of mental illness in Sagamu, Nigeria.	The findings were based on one location.
Abiodun (2006)	Postnatal depression in primary health care.	Women recruited 6 weeks postdelivery.	Prevalence 18.6%, depression predicted not having desired gendered baby (OR = 2.86; 95% CI = 1.62–5.93; p < 0.05).	EPDS should be incorporated into the routine screening.	Selection bias for those who are depressed and do not attend clinics.
Adewuya et al. (2005)	Post-traumatic stress disorder after childbirth.	876 women attending postnatal clinics at 6 weeks postpartum.	Prevalence for PTSD was 5.9%. Risk factor emergency caesarean section (OR = 7.31, 95% CI = 3.53–15.10).	PTSD is higher in Nigerian women than those in western cultures.	PTSD symptoms may have existed before childbirth.
Ukpong et al. (2003)	Psychological distress in the postpartum period.	33 preterm neonates and 27 mothers of full-term infants.	Mothers of preterm neonates significantly experienced more emotional distress and depression than full-term normal.	A multidisciplinary approach to address postnatal distress.	Neonatal health status could have affected maternal wellbeing.
Adewuya et al. (2005)	Sociodemographic and obstetric risk factors.	876 women recruited 6 weeks postpartum.	Depressed mothers statistically single mother (OR = 3.44, CI = 2.15–5.53), had emergency caesarean sections (OR = 3.58, CI = 1.72–7.48) and female babies (OR = 2.74, CI = 1.87–4.03).	Prevalence rates to be similar across cultures but identified risk factors to differ significantly.	A standard diagnostic instrument was not used to measure depression.
Lawal and Idemudia (2017)	Breastfeeding, self-efficacy, health locus of control on wellbeing.	291 breastfeeding mothers recruited Lagos state, Nigeria.	Breastfeeding self-efficacy influence sense of autonomy F(1, 283) = 31.183, p = 0.000, partial η2 = 0.099, positive relations with others F(1, 283) = 24.402, p = 0.000, partial η2 = 0.079, self-acceptance F(1, 283) = 37.043, p = 0.000, partial η2 = 0.116.	Breastfeeding mothers need to feel more confident in their breastfeeding abilities and feel they have control over their health.	The cross-sectional approach limit generalising the findings.
Fatoye et al. (2004)	Late pregnancy and matched controls for emotional distress.	156 pregnant women (gestational age 36 weeks or above) and 156 non-pregnant women.	Higher depression in pregnant (M = 33.58) than controls (M = 28.28) (t = 3.99, df = 310, p < 0.001). Higher mean anxiety (M = 39.29) than controls (M = 31.86) (t = 4.17, df = 310, p < 0.001). Polygamy, mode of previous delivery risk factors.	Women significantly had higher levels of anxiety and depression in late pregnancy compared to non-pregnant controls.	Participants were recruited from one health centre.
Ukpong and Owolabi (2006)	Postpartum emotional distress, caesarean section, vaginal delivery.	47 who had caesarean section and 47 matched controls who had a vaginal delivery.	The difference in mean scores for the index group 6.66 (6.37) was higher (p < 0.001) than the control group 1.23 (2.98). 42.5% of the women who has a caesarean significant emotional distress.	Caesarean childbirth may predispose Nigerian women to adverse psychological distress.	The data was self-reported, and therefore, response and sample biases may be present.
Tungchama et al. (2017)	Quality of Life of women with depression.	531 mothers 6–8 weeks postpartum in Nigeria.	Mothers had a significant poor perception of Quality of Life (QoL). Emergency caesarean significant (B = −11.89, p = 0.26).	The predictors of QoL indicated the outcome of postnatal depression in mothers.	Cross-sectional design limits the inference on the causality of the variables.
Adewuya et al. (2008)	Depression, postpartum and non-postpartum.	876 6 weeks postpartum, 900 matched non-postpartum.	Depression in 14.6% of postpartum and in 6.3% in the non-postpartum, significant (t = 8.919, df = 875, p < 0.001).	The prevalence of postnatal depression in Nigeria is comparable to Western.	Prevalence based on women who attended immunisation clinics.