妊娠期体质量增加与产后抑郁症关系的Meta分析

Relationship between Gestational Weight Gain and the Risk of Postpartum Depression:a Meta-Analysis

目的:采用Meta分析的方法系统评价妊娠期体质量增加(GWG)与产后抑郁症(PPD)的关系。方法:系统检索PubMed、Web of Science、Embase、中国知网(CNKI)、万方、维普等数据库从建库至2021年6月2日前公开发表、报道有关GWG与PPD的文献。采用RevMan 5.3软件和R 4.0.3软件进行Meta分析。结果:最终纳入文献6篇,研究对象共5084例。Meta分析结果显示:GWG不足(OR1.02,95%CI 0.77~1.36,P=0.880)或GWG过度(OR1.13,95%CI 0.85~1.49,P=0.400)均与PPD的发生无关。对GWG不足和GWG过度的每一篇文献采用逐一剔除法进行敏感性分析,新的合并OR值与原始合并OR值相比均未发生明显改变(P>0.05)。按照研究地区、研究类型、PPD标准、样本量和是否控制混杂因素进行亚组分析,GWG不足和GWG过度的各亚组间差异均无统计学意义(P>0.05)。结论:GWG不足或过度与PPD无关,未来的研究需要关注不同妊娠时期的体质量增加与PPD的关系。

Objective:To systematically review the relationship between gestational weight gain(GWG)and the risk of postpartum depression(PPD)by meta-analysis.Methods:A systematic search was performed in PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),Wanfang,and Weipu databases from inception to June 2,2021 to collect studies about GWG and PPD.Meta-analysis was performed using RevMan 5.3 and R 4.0.3 software.Results:Six studies involving 5084 participants were finally included.Meta-analysis showed that insufficient GWG(OR1.02,95%CI 0.77-1.36,P=0.880)or excessive GWG(OR1.13,95%CI 0.85-1.49,P=0.400)were not associated with PPD.The sensitivity analysis of each literature with insufficient GWG and excessive GWG was carried out one by one.The new combined OR value did not change significantly compared with the original combined OR value(P>0.05).Results of the subgroup analysis performed based on study region,study type,evaluation criteria for PDD,sample size and confounding factors did not show any inter-group difference(P>0.05)between the subgroups with insufficient GWG and excessive GWG.Conclusions:The findings showed that neither insufficient nor excessive GWG was associated with the risk of PPD.Further studies focusing on the relationship between weight gain during different gestational periods and PPD are needed.