中国女性产后抑郁发生率及影响因素meta分析

Prevalence and influencing factors of postpartum depression in Chinese women:a meta-analysis

目的 系统评价中国女性产后抑郁发生率及影响因素。方法 计算机检索中国生物医学文献服务系统、中国知网、维普资讯中文期刊服务平台、万方医学网、PubMed、EMbase、Web of Science等数据库中有关中国女性产后抑郁影响因素的病例-对照及横断面研究,检索时限从建库至2022年9月30日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后采用STATA16.0统计软件进行中国女性产后抑郁发生率及妊娠期焦虑与抑郁、经历负性生活事件、婴儿出现疾病、产妇睡眠质量差等中国女性产后抑郁影响因素的meta分析。结果 共纳入18篇文献,累计样本量23 511例,相关危险因素11项。中国女性产后抑郁发病率为16.0%。影响因素为妊娠期焦虑、妊娠期抑郁、经历负性生活事件、住房条件不佳、缺乏家庭支持、婴儿出现疾病、产妇睡眠质量差、家庭经济状况不佳、夫妻关系不和睦(优势比=2.31、2.46、1.75、2.75、1.83、1.64、1.74、2.09、2.63,95%可信区间:1.37~3.90、1.18~5.11、1.16~2.65、2.43~3.10、1.83~2.81、1.14~2.34、1.04~2.92、1.08~4.05、1.45~4.76)。结论 当前证据表明,中国女性产后抑郁患病率相对较高,妊娠期焦虑与抑郁、产妇住房条件不佳、家庭经济状况较差、夫妻关系不和睦、缺乏家庭支持、产妇睡眠质量差、经历负性生活事件、婴儿出现疾病等是中国女性产后抑郁症发病的影响因素。但该研究所得出的结论未来仍需更多大样本、多中心、高质量的研究进一步证实。

Objective To evaluate the prevalence and influencing factors of postpartum depression in Chinese women.Methods Case-control and cross-sectional studies on the influencing factors of postpartum depression in Chinese women were retrieved from Chinese BioMedical Literature Database,China National Knowledge Internet,VIP,WanFang,PubMed,EMbase and Web of Science.The retrieval period was from the establishment of the database to September 30,2022.Two researchers independently screened literature,extracted data,and evaluated the bias risk of included studies.Stata 16.0 software was used to conduct a meta-analysis on the prevalence of postpartum depression in Chinese women,as well as the influencing factors of postpartum depression in Chinese women,such as anxiety and depression during pregnancy,negative life events,infant disease,and poor maternal sleep quality.Results A total of 18 studies were included,with a cumulative sample size of 23511 and 11 risk factors.The results of meta-analysis showed that the incidence of postpartum depression in Chinese women was 16.0%,and the statistically significant influencing factors were pregnancy anxiety[OR=2.31,95%CI(1.37-3.90)],pregnancy depression[OR=2.46,95%CI(1.18,5.11)],experience negative life events[OR=1.75,95%CI(1.16-2.65)],poor housing conditions[OR=2.75,95%CI(2.43-3.10)],lack of family support[OR=1.83,95%CI(1.83-2.81)],infant disease[OR=1.64,95%CI(1.14-2.34)],poor maternal sleep[OR=1.74,95%CI(1.04-2.92)],poor family economic situation[OR=2.09,95%CI(1.08-4.05)],marital disharmony[OR=2.63,95%CI(1.45-4.76)].Conclusion Current evidence shows that the prevalence of postpartum depression in Chinese women is relatively high.Anxiety and depression during pregnancy,poor housing conditions for mothers,poor family economic status,marital disharmony,lack of family support,poor maternal sleep quality,negative life events,and infant disease are the influencing factors for the prevalence of postpartum depression in Chinese women.However,the conclusions of this study need to be further confirmed by more large-sample,multi-center and high-quality studies in the future.