高龄孕产妇抑郁相关危险因素的meta分析

Meta-analysis of risk factors associated with depression in advanced age

目的系统评价高龄孕产妇抑郁发病影响因素。方法检索中国知网、维普期刊库、万方数据库、PubMed、Embase、The Cochrane Library、Web of Science中探讨高龄孕产妇抑郁发病危险因素,时限为建库至2022年9月,并对纳入的文献进行质量评价与数据提取,采用RevMan5.4进行meta分析。根据异质性检验的结果选择相应效应模型进行数据合并,计算各因素合并比值比(OR)及其95CI。结果纳入文献7篇,纳入研究对象抑郁组1490例,正常组6073例,共7563例,纳入文献质量评价均在中等及以上。meta分析结果显示:年龄>40岁(OR=2.73,95%CI:1.06~7.02)、高中以下文化程度(OR=3.32,95%CI:1.34~8.18)、产前焦虑(OR=5.49,95%CI:3.87~9.11)、剖宫产(OR=1.79,95%CI:1.16~2.76)、新生儿健康异常(OR=1.24,95%CI:1.10~1.39)新生儿性别:女(OR=1.65,95%CI:1.08~2.15)是高龄孕产妇抑郁的危险影响因素。结论高龄孕产妇发生抑郁的概率相对偏高,要避免高龄孕产妇可能发生抑郁的危险因素,为临床工作提供干预措施及参考依据,以及时识别,尽早进行规范治疗,减少高龄孕产妇抑郁发生概率,降低母婴危害。

Objective To systematically evaluate the influencing factors of depression in elderly maternal age.Methods The risk factors for depression in elderly pregnant women were explored in CNKI,VIP Periodicals,Wanfang Database,PubMed,Embase,The Cochrane Library and Web of Science,and the risk factors for depression in elderly women were established until September 2022,and the quality evaluation and data extraction of the included literature were carried out,and RevMan5.4 was used for meta-analysis.Based on the results of the heterogeneity test,the corresponding effect model was selected for data pooling,and the combined odds ratio(OR)of each factor and its 95%CI were calculated.Results Seven articles were included,including 1490 cases in the depression group and 6073 cases in the normal group,with a total of 7563 cases,and the quality evaluation of the included literature was moderate or above.Meta-analysis showed that age>40 years(OR=2.73,95%CI:1.06—7.02),education level below high school(OR=3.32,95%CI:1.34—8.18),antenatal anxiety(OR=5.49,95%CI:3.87—9.11),cesarean section(OR=1.79,95%CI:1.16—2.76),neonatal health abnormalities(OR=1.24,95%CI:1.10—1.39)Neonatal gender:female(OR=1.65,95%CI:1.08—2.15)was a risk factor for maternal depression in advanced age.Conclusion The probability of depression in elderly pregnant women is relatively high,and it is necessary to avoid the risk factors for depression in elderly pregnant women,provide intervention and reference basis for clinical work,timely identification,and standardized treatment as soon as possible,so as to reduce the incidence of depression in elderly pregnant women and reduce the harm to mothers and infants.