Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei 230032, Anhui, China.
Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
J Affect Disord. 2014 Apr;159:103-10. doi: 10.1016/j.jad.2014.02.027. Epub 2014 Feb 26.
Previous studies concerning the association between maternal anxiety during pregnancy and adverse birth outcomes have provided controversial findings.
In this systematic review, a meta-analysis was utilized to investigate the association between maternal anxiety and preterm birth (PTB) and/or low birth weight (LBW). Literature was searched until June 2013. Only prospective cohort studies that reported data on maternal anxiety during pregnancy with PTB and/or LBW were included. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using fixed or random effects models depending on the size of heterogeneity.
Twelve studies totaling 17,304 pregnant women reported PTB data; and six studies totaling 4948 pregnant women reported LBW data. Maternal anxiety during pregnancy was associated with significant increased risk of PTB (pooled RR=1.50, 95% CI=1.33-1.70) and LBW (pooled RR=1.76, 95% CI=1.32-2.33).
Potential moderators could not be adequately considered due to insufficient information. In addition, the effects of different types of anxiety disorder on the risk of these adverse birth outcomes could not be investigated.
The results suggested that maternal anxiety during pregnancy was positively related to an increased risk of PTB and LBW. Healthcare providers should give close attention to anxiety in pregnant women and provide appropriate mental health support in order to improve outcomes for both mothers and infants.
先前有关孕妇焦虑与不良出生结局之间关系的研究结果存在争议。
本系统评价采用荟萃分析方法，旨在探讨孕妇焦虑与早产（PTB）和/或低出生体重（LBW）之间的关系。文献检索截至 2013 年 6 月。仅纳入报道了孕期焦虑与 PTB 和/或 LBW 相关数据的前瞻性队列研究。采用固定或随机效应模型计算汇总相对风险（RR）及其 95%置信区间（CI），取决于异质性的大小。
共有 12 项研究（总计 17304 名孕妇）报告了 PTB 数据，6 项研究（总计 4948 名孕妇）报告了 LBW 数据。孕期焦虑与 PTB（汇总 RR=1.50，95%CI=1.33-1.70）和 LBW（汇总 RR=1.76，95%CI=1.32-2.33）的风险显著增加相关。
由于信息不足，无法充分考虑潜在的调节因素。此外，不同类型的焦虑障碍对这些不良出生结局风险的影响也无法进行研究。
研究结果表明，孕妇焦虑与 PTB 和 LBW 的风险增加呈正相关。医疗保健提供者应密切关注孕妇的焦虑情况，并提供适当的心理健康支持，以改善母婴结局。
