Oxytocin levels and postnatal depression among Asian postpartum mothers: A Scoping Review

Abstract

Depression among mothers after delivery is one of the mental health issues caused by several factors, such as biological, psychological, and social. Several researchers have investigated the relationship of oxytocin levels among postpartum mothers. Oxytocin is a neuropeptide that has been studied as a potential biomarker for postpartum depression associated with social bonding and maternal behaviours. However, the results remained inconsistent, especially within the Asian country. The objective of this scoping review is to understand the relationship between oxytocin levels and postnatal depression among postpartum mothers in Asian countries from the existing literature and to recognise research gaps for future study. This scoping review synthesises existing literature from studies conducted in Asian countries to evaluate the relationship between oxytocin levels and symptoms of postnatal depression. The selected followed the PRISMA framework for identifying, screening, and selecting relevant studies. Three databases were utilised in the scoping review: PubMed (n = 79), Scopus (n = 108), and Web of Science (n = 116) totalling 303 studies. A total of 125 duplicate studies were excluded. Based on the title and abstract, 150 studies were excluded. Twenty-eight full-text articles were assessed for eligibility, with 19 excluded for non-fulfilment of the predetermined inclusion criteria. Finally, nine studies were included in this final review. The studies varied in design, including longitudinal, cross-sectional, and retrospective approaches. Oxytocin levels were measured through serum or saliva, while depression symptoms were assessed using validated scales, such as the Edinburgh Postnatal Depression Scale (EPDS), the Patient Health Questionnaire-9 (PHQ-9), and the Maternity Blues Scale. Several studies reported a significant relationship between oxytocin levels and depressive symptoms, particularly in the early postpartum period. Other studies found no statistically significant association. Some investigations focused on related outcomes such as maternal anxiety or mother-infant bonding. Methodological variations, including differences in measurement timing, sample size, and psychological tools, contributed to the heterogeneity of results. Current evidence does not conclusively establish oxytocin as a standalone predictive biomarker for postnatal depression. However, its potential role as part of a multidimensional assessment warrants further investigation. Longitudinal studies with standardised measurement protocols and controls for psychosocial variables are recommended to better understand the oxytocin-PPD relationship. Furthermore, a future review on the larger area captures the postnatal depression among postpartum mothers.