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Abstract Background Long-COVID research to date focuses on outcomes in non-hospitalised vs. hospitalised survivors. However Emergency Department attendees (post-ED) presenting with acute COVID-19 may experience less supported recovery compared to people admitted and discharged from hospital (post-hospitalised group, PH). Objective We evaluated outcomes and predictors of specialty care referrals (SCR) in those with ongoing symptomatic Long-COVID, comparing post-ED and PH adults. Methods This prospective observational cohort study evaluates 800 PH and 484 post-ED adults from a single hospital in London, United Kingdom. Participants had either confirmed laboratory-positive SARS-CoV-2 infection or clinically suspected acute COVID-19 and were offered post-COVID clinical follow-up at approximately six weeks after their ED attendance or inpatient discharge, to assess ongoing symptoms and support recovery. Multiple logistic regression determined associations with specialist care referrals (SCR) to respiratory, cardiology, physiotherapy (including chest physiotherapy), and mental health services. Results Presence of at least one Long-COVID symptom was lower in adults attending ED services with acute COVID-19 compared to those hospitalised (70.1% post-ED vs. 79.5% PH adults, p

This study aim is to examine the effect of Demographic characteristics of the board of directors (Women on corporate board, Board size, Auditing firm, Size of a firm, Leverage and return on equity) on Tax Avoidance using a sample of30 big firms from different sectors listed in the stock exchange of Pakistan from 2010 to 2019. The study uses secondary data taken from the Balance Sheet of firms and SCS trade. To analyze the data, the Panel data regression model used to observe the result of the demographic characteristics of the board of directors on tax avoidance. The results indicate that a firm audited by Big-4 reduces the corporate tax avoidance. Additionally, firms with a larger size of board of directors are associated with more tax avoidance. However, the presence of women on the board of directors does not reduce the corporate tax avoidance.

Social isolation and loneliness are major health concerns for older adults in the United States. This scoping review examines the effectiveness of intergenerational interventions aimed at reducing social isolation and loneliness among older adults in the United States, specifically through programs that engage university students from healthcare-related fields in one-on-one settings with older adults, as reports of lacking geriatric training of healthcare students causes older adult neglect to persist in the healthcare workforce. The importance of addressing these issues is underscored by significant health risks and substantial economic burdens, with social isolation and loneliness potentially increasing mortality and costing Medicare an estimated $6.7 billion annually. Covering literature from 2010 to 2022, this review critically assesses the role of such interventions in fostering social connections and improving both physical and mental health outcomes. Despite the positive preliminary results indicating significant reductions in loneliness and enhancements in social networks among participants, the review highlights considerable gaps in current research, particularly in structured intervention curricula, demographic reporting and detailed intervention descriptions. This underscores the need for more rigorous and standardized research methodologies to better understand the effectiveness and potential of intergenerational programs as interventions against the detrimental effects of social isolation and loneliness among older adults.

Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, is a rare painful skin condition that is characterized by hyperpyrexia, peripheral blood and skin neutrophilia, and edematous skin lesions. Necrotizing SS (NSS) is a severe and locally aggressive condition that histopathologically resembles a necrotizing soft tissue infection. As opposed to necrotizing soft tissue infections, NSS responds to systemic steroids. SS is divided into three subtypes: classical SS, malignancy-associated SS, and drug-induced SS. Within the malignancy-associated SS subtype, both solid tumor and hematologic malignancies have been precursors to developing SS. Here, we present a case of acute myeloid leukemia-associated NSS.

Purpose: The main aim of this study was to investigate the factors that influence the customers’ behavioral intention to adopt financial technologies (Fin-tech) in the banking sector of Pakistan. These factors include perceived usefulness, perceived ease of use, attitude towards use, environmental concerns and demographic variable age was taken as moderator in this study. Design/Methodology/Approach: The primary data was collected from 600 customers of the banking sector located in the region of southern Punjab, Pakistan, using simple random sampling techniques from those who are using technologies for their financial activities. The five-point Likert scale was used for data collection and the Google form was used to collect the data as this is the most efficient way. Findings: The findings of this study reveal that many factors including perceived usefulness, perceived ease of use, attitude towards use, and environmental concerns play a positive and significant role in the adoption of financial technologies for their business activities for the customers of the banking sector. At the same time, age was taken as a moderator which significantly moderated the relationship between environmental concerns and behavioral intention to adopt fin-tech. Implications/Originality/Value: This study gave a detailed understanding of the factors influencing the adoption of Fin-Tech and is also helpful for the researchers, academician, business owners and policymakers for taking decision-makers about enhancing financial activities and getting more efficient and effective responses from the customers for adopting the financial technologies for their business activities and also generate a valuable business for their organizations.

This study examined the potential impacts of entrepreneurial leadership on followers' psychological wellbeing and proactive work behavior through sustainable employability and work uncertainty in a sample of 218 employees employed in SMEs of Pakistan. Hierarchical regression results demonstrated that entrepreneurial leadership was positively connected with sustainable employability and negatively linked with work uncertainty. Sequentially, sustainable employability was positively correlated with proactive work behavior and employees' psychological wellbeing, and work uncertainty was negatively associated with proactive work behavior and employees' psychological wellbeing during the COVID-19 crisis. Furthermore, bootstrapping confirmed the mediation effects of work uncertainty and sustainable employability on proactive work behavior and the psychological wellbeing of employees. Sustainable employability did not mediate the relationship between entrepreneurial leadership and psychological wellbeing. Mediators, sustainable employability, and work uncertainty positively linked employees' psychological wellbeing and proactive work behavior. The results highlighted the significant roles of sustainable employability and work uncertainty and interpreted why entrepreneurial leadership may affect employees' positive behaviors.

This paper focused on human resource issues in a private sector organization. The study adopted a qualitative approach, using Systemic Intervention to identify and develop solutions to tackling human resource issues through the engagement of relevant stakeholders in the organizational operations. Interviews, workshops, and boundary critique were used for data collection. Collected data were sorted for thematic analysis. Critical issues identified in the research process included frequent junior staff turnover challenges, general human resource security, junior staff’s educational qualification, and irregular work schedule. Findings showed that joint participation in the research process enables learning among participants from across the case study organization structure. It also provided a significant platform for the exploration of diverse opinions and perspectives of participants. A reflection on the qualitative methodology showed the usefulness of combining techniques and methods from different methods in addressing complex human resource issues. However, it is noted that the implementation of developed solutions requires continuous evaluation to maintain effectiveness in systemic intervention. The study concluded with the suggestion for further research to use various methods to explore the influence(s) of external factors on internal human resource challenges, especially in the private sector and a developing economy such as Nigeria.

ABSTRACT Purpose: The purpose of this research is to examine the impact of internal corporate governance mechanisms on the social performance of microfinance institutions of Pakistan. Design/Methodology/Approach: A survey questionnaire was used to collect data. Data were collected manually and online (Google survey form). The data collected were analyzed through Smart PLS. Findings: The results showed that board of directors, board meetings and frequency of board meetings as components of internal corporate governance mechanism have a positive and significant impact on the social performance of microfinance institutions of Pakistan. Implications/Originality/Value: The originality and contribution of this study is that this is the first study that analyzed the impact of board of directors, board meetings and frequency of board meetings as a component of internal corporate governance mechanism on the social performance of microfinance institutions of Pakistan.

Cryptocurrency could redefine the interplay of Internet-connected world markets by eliminating constraints set by traditional local currencies and exchange rates. It has the potential to revolutionise digital markets through the use of duty-free trading. This study investigates the factors which influence the behavioural intention to use cryptocurrency based on the Technology Acceptance Model 3 (TAM 3) during the COVID-19 (SARS-COV-2) pandemic. Data were collected through a cross-sectional questionnaire from 357 Pakistani business-educated adults, including investors who had a rudimentary understanding of the technology and financial instruments. Partial least square (PLS)-based structural equation modeling (SEM) was used to test the developed theoretical framework based on the Technology acceptance model 3. The PLS model has explained 72.1% of what constitutes the behavioural intention to use cryptocurrency. Surprisingly, risk was not a major consideration. This might be due to the fact that the majority of respondents thought working with cryptocurrency was hazardous. Willingness to handle cryptocurrency risk, on the other hand, might be a stumbling block to acceptance. The most essential aspect of a cryptocurrency's success was the perceived usefulness. Moreover, the moderating role of experience was not substantiated in this study. However, perceived usefulness was identified as a partial mediator of subjective norm and the perceived ease to use. This study contributed to the literature through the application of TAM 3 (an extension of the technology acceptance models) to investigate the fundamental qualities a cryptocurrency should have in order to influence investor's behavioural intention to use it. These findings provide revolutionary insights for the present and future market players for investment planning and for improved cryptocurrencies development.

Workplace deviant behavior (WDB) and workplace ostracism (WO) have emerged as one of the most toxic behaviors that breed self-protection and self-interest in today’s organizations. However, limited evidence is available on the underlying factors, such as organizational conflict (OC), knowledge-sharing behavior (KSB) and emotional intelligence (EI), in explaining the WO-WDB relationship. Hence, the present study aims to introduce and empirically validate a moderated-mediation model of workplace deviant behavior, involving WO, OC, KSB and EI, respectively. Drawing on study data from 250 officials in the higher education public sector institutions in Pakistan, and employing structural equation modeling with partial least squares, the findings revealed a significant positive effect of WO on WDB. Besides the validation of the mediating roles of OC and KSB, the findings also confirmed a significant moderating influence of EI. The study implications provide theoretical and practical insights to better interpret KSB, OI and EI in organizations that can generate effective deterrence towards WO and WDB.

Inspired by the global increase in awareness of corporate social responsibility (CSR), this paper is an attempt to explore the influence of CSR on bank employees’ satisfaction and loyalty and banks’ financial performance. It was assumed there could be differences in the perception of CSR among employees toward the CSR initiatives being undertaken by the banks they work for. Employees’ level of awareness and extent of involvement with various CSR activities could affect their satisfaction and loyalty. This study used regression analysis for hypothesis testing. Its findings reveal that CSR positively affects employee satisfaction and loyalty as well as banks’ financial performance; employee satisfaction positively affects employee loyalty; and employee loyalty positively affects banks’ financial performance. Hence, bank management should focus on CSR from the perspective of employees to contribute to employee satisfaction and loyalty, and ultimately, to enhanced financial performance. Suggestions and inferences for future research and banking sector practices are suggested based on these results.

This study empirically studies the impacts of micro-credit finance on the socio-economic status of small agriculturists in Pakistan. Little research has been conducted in this area in Pakistan. The data was gathered from 693 micro-credit finance participants and non-participants, at a 2 to 3 ratio, through an adapted questionnaire from the 8-clusters out of 12 clusters of 36 districts of Punjab using the cluster sampling technique. A survey was organized to perform the investigation in which two close-ended structured questionnaires were developed to collect data from the small agriculturists who owned less than twelve and a half acres of land. Both descriptive and inferential statistics were used to analyze the results of the study. Various statistical tests, such as EFA, SEM, KMO, ANOVA tests, etc., were used to test the expected hypothesis of the study and to confirm the affinity among variables. This research revealed that micro-credit finance has performed a positive role in developing the socio-economic status of small agriculturists after obtaining the micro-credit finance. The study indicated that micro-credit finance has played a significant role in changing and developing the socio-economic status of the respondents. Participation of small agriculturists enables the poor masses of rural areas to eradicate poverty in rural areas to enhance their living standards and to strengthen their financial conditions. The end results of the study revealed that most small agriculturists were taking benefits from micro-credit lending schemes. They also improved their socio-economic status and mitigated poverty. The findings of the study provide profound insight and should be helpful to regulators, policy makers, managers, microfinance institutions, government authorities, and all other stakeholders.

The purpose of this study is to investigate the impact of micro-credit finance on over-indebtedness and social & financial mobility of micro-credit finance participants. The objectives of this research is to investigate that micro-credit finance participation leads to over-indebtedness of micro-credit finance and over-indebtedness of micro-credit finance effect the social and financial mobility of micro-credit finance participants. The study also investigates the role of women participation in those financial decisions through which over-indebtedness exist. The study is quantitative and the research design is explanatory in nature. The data was collected from 266 current and ex-micro-credit finance participants through questionnaire and interview were also conducted in order to facilitate respondents. The data was analyzed through different statistical software I.e. Microsoft Excel and SPSS. The findings of the study indicate that micro-credit finance participants experience over-indebtedness by participation in micro-credit finance program but it does not affect the social and financial mobility of micro-credit finance participants. It also evaluate that women involvement has weak mediating relation with over-indebtedness and financial mobility. This study has important implications because it provides insights regarding over-indebtedness of micro-credit finance participants that effects their social & financial mobility. This study also helps policy makers in formulating new regulations in the area of micro-credit finance sector in Pakistan. The new policies may target the aspect of over-indebtedness among micro-credit participants in future.

The global temperature has reached its highest level since the start of the industrial revolution, which is the major cause of global warming. Global warming has become one of the gravest problem now a days as it has considerable influences over markets, societies and economies. For sustainable environment management, remarkable efforts are carried out across the world and every institution is playing its role towards minimizing its impact on the environment. From financial institutions, banking sector is playing an important role in this regard. Banking sector has introduced a concept of Green Banking (GB). State Bank of Pakistan (SBP) has recently issued guidelines regarding the adoption of green banking. This study attempts to identify the factors which affect bankers’ intension to adopt green banking. This study would prove to be helpful in identifying the most influencing factors towards adoption of green banking practices and in developing policies towards its adoption in Pakistan. Structured questionnaire based on a 7 point Likert scale as used for data collection from a sample of 300 respondents. Regression analysis was used to check the association among the variables. The result of study shows that all independent variables of study have shown significant association with dependent variable. Which means to some extent every independent factor is playing role in affecting bankers’ behavioral intension to adopt green banking. Result shows that perceived usefulness and perceived ease of use contribute more in predicting the Attitude toward use, which along with effort expectancy and performance expectancy are major contributing factors towards behavioral intention to adopt green banking practices.

Savings is potential solution to consume the scarce resources in an efficient way, which helps large scale production, improved productivity of the labor and result in increased economic development. The purpose of this study is to examine how macroeconomic indicators like GDP growth rate, income, inflation rate and interest rate affect gross national savings rate of Pakistan and how political stability influence the relationship between these four macroeconomic indicators and savings rate. Using 10 years macroeconomic data of Pakistan from year 2006-2015, multiple regression analysis technique was run and it was found that all four macroeconomic indicators significantly affects the savings rate. Income appeared to be strongest predictor in causing an increase in the savings rate. Although GDP found to be have an inverse relationship with savings rate. Political stability appeared to be non-significant in influencing the relationship between macroeconomic factors and savings rate.

Background As medical education programs transition to competency-based medical education (CBME), experiences transitioning in the context of small subspecialty programs remain unknown, yet they are needed for effective implementation and continual improvements. Objective To examine faculty and resident experiences transitioning to CBME in a small subspeciality program. Methods Using a qualitative descriptive approach and constructivist lens, faculty and residents in McMaster University's geriatric psychiatry subspecialty program were interviewed about their transition experiences between November 2021 and February 2022, after the program's soft launch of CBME in 2020. Interviews were transcribed and data were analyzed using thematic analysis. Reflexive memo writing and investigator and data triangulation strategies were employed to ensure rigor and trustworthiness of the data. Results Ten of the 17 faculty members (59%) and 3 residents (100%) participated. Six themes were developed: (1) Both faculty and residents see themselves as somewhat knowledgeable about CBME, but sources of knowledge vary; (2) More frequent feedback is beneficial; (3) Aspects of CBME that are challenging for residents are beneficial for faculty; (4) Competence committees are perceived positively despite most participants' limited firsthand experience with them; (5) Small program size is both a barrier and facilitator to providing and receiving feedback; and (6) Suggestions for improvement are centered on helping manage faculty and resident workload imposed by CBME. Conclusions Incongruent expectations surrounding entrustable professional activity management were highlighted as an area requiring support. Collegial relationships among faculty and residents made it difficult for faculty to provide constructive feedback but improved residents' perceptions of the feedback.

Objectives: To describe screen time levels and determine their association with socioemotional and behavioural difficulties among preschool-aged First Nations, Métis, and Inuit children., Method: Data were taken from the Aboriginal Children's Survey, a nationally representative survey of 2-5-year-old Indigenous children in Canada. Socioemotional and behavioural difficulties were defined using parent/guardian reports on the Strengths and Difficulties Questionnaire. Multiple linear regression analyses were conducted separately for First Nations, Métis, and Inuit participants, and statistically adjusted for child age, child sex, and parent/guardian education. Statistical significance was set at P  < 0.002 to adjust for multiple comparisons., Results: Of these 2-5-year-old children ( mean [ M ] = 3.57 years) 3,085 were First Nations (53.5%), 2,430 Métis (39.2%), and 990 Inuit (7.3%). Screen time exposure was high among First Nations ( M  = 2 h and 58 min/day, standard deviation [ SD ] = 1.89), Métis ( M  = 2 h and 50 min [ SD  = 1.83]), and Inuit children ( M  = 3 h and 25 min [ SD  = 2.20]), with 79.7% exceeding recommended guidelines (>1 h/day). After adjusting for confounders, screen time was associated with more socioemotional and behavioural difficulties among First Nations (total difficulties β  = 0.15 [95% CI, 0.12 to 0.19]) and Métis ( β  = 0.16 [95% CI, 0.12 to 0.20]) but not Inuit children ( β  = 0.12 [95% CI, 0.01 to 0.23])., Conclusions: Screen time exposure is high among Indigenous children in Canada, and is associated with more socioemotional and behavioural difficulties among First Nations and Métis children. Contributing factors could include enduring colonialism that resulted in family dissolution, lack of positive parental role models, and disproportionate socioeconomic disadvantage. Predictors of poor well-being should continue to be identified to develop targets for intervention to optimize the health and development of Indigenous children., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: The common peroneal nerve (CPN) palsy in military personnel due to chronic exertional compartment syndrome (CECS) is uncommon. There are no previous reports of treatment of this condition with simultaneous CPN and superficial peroneal nerve (SPN) neurolysis and compartment release., Case Report: An 18-year-old military recruit presented with complete CPN palsy after sitting cross-legged for 2 h in training. After 3 months of failed non-operative treatment, a clinical diagnosis of CECS with CPN palsy was made and the patient was treated with simultaneous CPN and SPN neurolysis and release of the anterior and lateral leg compartments. The patient had full recovery at 6 months post-operative period and returned to sports at 1 year follow-up., Conclusion: This case report of a young military recruit with CPN palsy after prolonged cross-legged sitting in the setting of CECS demonstrates successful treatment with simultaneous CPN and SPN neurolysis and anterior and lateral compartment release. Future studies should explore the efficacy of this treatment option and prevention strategies of CPN palsy in military personnel., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Background: Dietary interventions are a widely available mediation for depression and anxiety among pregnant and/or postpartum (i.e., perinatal) persons, but their effectiveness is not well known., Objectives: We performed a systematic review and meta-analysis to assess the effectiveness of dietary interventions for the treatment of perinatal depression and/or anxiety., Methods: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science from their inception to 2 November, 2022. Studies were included if they were available in English and examined the effectiveness of a dietary intervention for perinatal depression and/or anxiety in a randomized controlled trial., Results: Our search identified 4246 articles, of which 36 were included and 28 were eligible for meta-analysis. Random-effects meta-analyses were performed. Polyunsaturated fatty acids (PUFAs) were not found to improve symptoms of perinatal depression compared to control conditions [standardized mean differences (SMD): -0.11; 95% CI: -0.26 to 0.04]. These results neither changed when examined during pregnancy or the postpartum period separately nor varied according to the fatty acid (FA) ratio. Elemental metals (iron, zinc, and magnesium) were also not found to be superior to placebo (SMD: -0.42; 95% CI: -1.05 to 0.21), although vitamin D yielded a small to medium effect size improvement (SMD: -0.52; 95% CI: -0.84 to -0.20) in postpartum depression. Iron may help in those with confirmed iron deficiency. Narrative synthesis was performed for studies ineligible for meta-analyses., Conclusions: Despite their widespread popularity, PUFAs and elemental metals do not appear to effectively reduce perinatal depression. Vitamin D taken in doses of 1800-3500 International Units per day may be, to some extent, promising. Additional high-quality, large-scale randomized controlled trials are needed to determine the true effectiveness of dietary interventions on perinatal depression and/or anxiety. This study was registered at PROSPERO (registration date: 5 July, 2020; CRD42020208830)., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Urolithiasis is a common preventable ailment. Previous studies showed that there are a lot of factors, such as dietary, health and environmental factors, which are likely to develop this condition. Only a few research have been conducted on urolithiasis in the UAE. Therefore, our study aimed to identify the factors associated with urolithiasis in the country, identify the symptoms of urolithiasis among the cases and identify the most common diagnostic methods., Methodology: It was a case-control study design. The study population was adults above 18 years attending a tertiary care centre. Those who have confirmed diagnosis of urolithiasis and gave informed consent were considered cases and those who have not confirmed diagnosis of urolithiasis as controls. Patients with renal, bladder or urinary tract impairment or anomaly were excluded from the study. Ethical approval was obtained for the study., Results: Crude odds ratio (OR) showed that age, gender, past treatment for urinary stones, and lifestyle factors such as diet and smoking are risk factors while exercising is a protective factor. Age-adjusted OR found that past treatment for the urinary disease (OR=10.4), consumption of oily food (OR=11.5), consumption of fast food (OR=11.0) and consumption of energy drinks (OR=5.9) were the significant risk factors for urolithiasis., Conclusion: We found that past urinary disease treatment and diet are vital in developing urinary stones. Higher consumption of salty, oily, sugary and protein foods increases the odds of urinary diseases. Public awareness programs are essential to educating people about urolithiasis risk factors and preventive measures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Owais et al.)

Objective: Parental psychopathology is a significant risk factor for mental health challenges in offspring, but the nature and magnitude of this link in Indigenous Peoples is not well understood. This systematic review examined the emotional and behavioral functioning of the offspring of Indigenous parents with mental health challenges., Method: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until April 2020. Studies were included if they included assessments of emotional, behavioral, or other psychological outcomes in the offspring of Indigenous parents with a mental health challenge., Results: The 14 studies eligible for review were focused on parental substance misuse ( n = 8), maternal internalizing (i.e., depression, anxiety) issues ( n = 5), and poor overall parental mental health ( n = 4). In 11 studies, parental substance misuse, depression, and/or overall mental health challenges were associated with 2 to 4 times the odds of offspring externalizing and internalizing behaviors as compared to offspring of Indigenous parents without mental health challenges., Conclusion: The findings suggest higher risks of mental health challenges among offspring of Indigenous parents with psychiatric difficulties than among Indigenous children of parents without similar difficulties. Knowledge of these phenomena would be improved by the use of larger, more representative samples, culturally appropriate measures, and the engagement of Indigenous communities. Future studies should be focused on both risk and resilience mechanisms so that cycles of transmission can be interrupted and resources aimed at detection, prevention, and treatment optimally allocated.

Background: Several coronavirus vaccine have been fast-tracked to halt the pandemic, the usage of immune adjuvants that can boost immunological memory has come up to the surface. This is particularly of importance in view of the rates of failure of seroconversion and re-infection after COVID-19 infection, which could make the vaccine role and response debatable. Peroxisome proliferator-activated receptors (PPARs) have an established immune-modulatory role, but their effects as adjuvants to vaccination have not been explored to date. It is increasingly recognized that PPAR agonists can upregulate the levels of anti-apoptotic factors such as MCL-1. Such effect can improve the results of vaccination by enhancing the longevity of long-lived plasma cells (LLPCs). The interaction between PPAR agonists and the immune system does not halt here, as T cell memory is also stimulated through enhanced T regulatory cells, antagonizing PD-L1 and switching the metabolism of T cells to fatty acid oxidation, which has a remarkable effect on the persistence of T memory cells. What is even of a more significant value is the effect of PPAR gamma on ensuring a profound secretion of antibodies upon re-exposure to the offending antigen through upregulating lipoxin B4, therefore potentially assisting the vaccine response and deterring re-infection., Short Conclusion: In view of the above, we suggest the use of PPAR as adjuvants to vaccines in general especially the emerging COVID-19 vaccine due to their role in enhancing immunologic memory through DNA-dependent mechanisms.

Objective: Although Indigenous women are exposed to high rates of risk factors for perinatal mental health problems, the magnitude of their risk is not known. This lack of data impedes the development of appropriate screening and treatment protocols, as well as the proper allocation of resources for Indigenous women. The objective of this systematic review and meta-analysis was to compare rates of perinatal mental health problems among Indigenous and non-Indigenous women., Methods: We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until February 2019. Studies were included if they assessed mental health in Indigenous women during pregnancy and/or up to 12 months postpartum., Results: Twenty-six articles met study inclusion criteria and 21 were eligible for meta-analysis. Indigenous identity was associated with higher odds of mental health problems (odds ratio [ OR ] 1.62; 95% confidence interval [CI], 1.25 to 2.11). Odds were higher still when analyses were restricted to problems of greater severity ( OR 1.95; 95% CI, 1.21 to 3.16) and young Indigenous women ( OR 1.86; 95% CI, 1.51 to 2.28)., Conclusion: Indigenous women are at increased risk of mental health problems during the perinatal period, particularly depression, anxiety, and substance misuse. However, resiliency among Indigenous women, cultural teachings, and methodological issues may be affecting estimates. Future research should utilize more representative samples, adapt and validate diagnostic and symptom measures for Indigenous groups, and engage Indigenous actors, leaders, and related allies to help improve the accuracy of estimates, as well as the well-being of Indigenous mothers, their families, and future generations., Trial Registration: PROSPERO-CRD42018108638.