地域分布及评定方法的差异对中国女性妊娠期抑郁检出率的影响

The impact of regional distribution and differences in assessment methods on the detection rate of depression during pregnancy in Chinese women

目的分析不同地域分布及评定方法对中国女性妊娠期抑郁检出率的影响。方法利用Meta分析方法,对中国女性妊娠期抑郁检出率进行系统描述,并阐明不同地域分布及评定方法对其产生的影响。结果最终纳入39篇文献,共102533名孕妇,检出妊娠期抑郁者24005例,检出率为22%(95%CI:18%~27%),妊娠早期和晚期的抑郁检出率分别为25%(95%CI:18%~33%)、20%(95%CI:15%~25%)。地域分布亚组分析发现:华东地区妊娠期抑郁的检出率相对较低,为18%(95%CI:13%~23%)。华南地区、西南地区、华北地区及其他地区妊娠期抑郁检出率分别为27%(95%CI:14%~41%)、21%(95%CI:14%~29%)、31%(95%CI:18%~44%)、22%(95%CI:12%~31%)。评定方法亚组分析发现:应用爱丁堡产后抑郁量表(EPDS)、抑郁筛查量表(PHQ-9)、抑郁自评量表(SDS)及其他量表进行妊娠期抑郁筛查的结果分别为24%(95%CI:20%~28%)、20%(95%CI:9%~31%)、39%(95%CI:23%~55%)、10%(95%CI:7%~12%)。结论中国女性妊娠早期抑郁的检出率较晚期高,华南、华北地区妊娠期抑郁检出率较高,不同的量表筛查出的妊娠期抑郁检出率亦有所不同。

Objective To analyze the impact of regional distribution and assessment methods on the detection rate of depression during pregnancy in Chinese women.Methods A meta-analysis was used to systematically describe the detection rate of depression during pregnancy in Chinese women and to clarify the effects of different regional distribution and assessment methods.Results This study finally included 39 articles,comprising 102533 pregnant women,with 24005 cases of detected depression during pregnancy,yielding a detection rate of 22%(95%CI:18%-27%).The detection rates of depression during the first and third trimester of pregnancy were 25%(95%CI:18%-33%),20%(95%CI:15%-25%),respectively.Subgroup analysis by regional distribution found that the detection rate of prenatal depression in East China was relatively low at 18%(95%CI:13%-23%),and the detection rate in South China,Southwest China,North China and other regions were 27%(95%CI:14%-41%),21%(95%CI:14%-29%),31%(95%CI:18%-44%),and 22%(95%CI:12%-31%),respectively.Subgroup analysis of assessment methods showed that the results of screening for depression during pregnancy using the Edinburgh postnatal depression scale(EPDS),the patient health questionnaire-9(PHQ-9),the self-rating depression scale(SDS),and other scales were 24%(95%CI:20%-28%),20%(95%CI:9%-31%),39%(95%CI:23%-55%)and 10%(95%CI:7%-12%),respectively.Conclusion The detection rate of depression during pregnancy in the first trimester is higher than that in the second and third trimester,and the higher detection rates are found in South China and North China.Different assessment scales yield varying detection rates for depression during pregnancy.