Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
BJOG. 2017 Apr;124(5):742-752. doi: 10.1111/1471-0528.14184. Epub 2016 Jun 20.
Migrant women are at risk of perinatal mental disorders due to stressors experienced before, during and after migration.
This systematic review and meta-analysis summarises the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC).
We systematically searched nine electronic databases and the grey literature using a predefined search strategy.
Studies were included if they assessed pregnant or postpartum migrants from LMIC, used a structured tool and a case-control, cross-sectional, cohort or intervention study design.
Data was double-extracted. We calculated pooled prevalence of depression and weighted mean anxiety and depression scores. We calculated crude odds ratios from risk factor studies and summarised intervention studies descriptively.
Forty studies were identified from 10 123 references. Pooled prevalence was 31% [95% condidence interval (CI) 23%-40%] for any depressive disorder and 17% (95% CI 12-23%) for major depressive disorder. Previous depression and lower social support were associated with perinatal depression. There were insufficient data to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population.
One in three migrant women from LMIC experiences symptoms of perinatal depression. Social support is an important protective factor. Evidence on LMIC women relocating to other LMIC is lacking. Given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority.
One in three migrant women from low- and middle-income countries has symptoms of perinatal depression.
由于移民前、中、后所经历的压力，移民妇女有患围产期精神障碍的风险。
本系统评价和荟萃分析总结了来自中低收入国家（LMIC）的移民妇女围产期精神障碍的患病率、相关因素和干预措施。
我们系统地检索了九个电子数据库和灰色文献，使用了预先设定的搜索策略。
如果研究评估了来自 LMIC 的孕妇或产后移民，使用了结构化工具和病例对照、横断面、队列或干预研究设计，则纳入研究。
数据由两人双份提取。我们计算了抑郁的汇总患病率，以及焦虑和抑郁评分的加权均数。我们从危险因素研究中计算了未校正的优势比，并对干预研究进行了描述性总结。
从 10123 篇参考文献中确定了 40 项研究。任何抑郁障碍的汇总患病率为 31%（95%置信区间[CI]23%-40%），重度抑郁障碍的患病率为 17%（95%CI12%-23%）。既往抑郁和较低的社会支持与围产期抑郁相关。由于数据不足，无法评估该人群中焦虑、创伤后应激障碍或精神病的负担。
来自 LMIC 的三分之一移民妇女经历围产期抑郁症状。社会支持是一个重要的保护因素。关于移民妇女从中等收入国家迁往其他中等收入国家的证据不足。鉴于围产期精神疾病对妇女及其子女的不良后果，在资源匮乏的环境中开展进一步研究是当务之急。
来自中低收入国家的三分之一移民妇女有围产期抑郁症状。
