Departments of Mental Health, and
Dartmouth Geisel School of Medicine, Hanover, New Hampshire.
Pediatrics. 2017 Mar;139(3). doi: 10.1542/peds.2016-1870. Epub 2017 Feb 21.
Parents whose infants are being treated in the NICU are at high risk for depression and anxiety, with negative implications for parenting and infant development.
We conducted a systematic review and meta-analysis of NICU-based interventions to reduce maternal depressive or anxiety symptoms.
PubMed, Embase, PsychInfo, Cochrane, and CINAHL were searched for relevant studies. Reference lists from selected studies were reviewed.
Inclusion criteria included randomized controlled design, a parent-focused intervention delivered in the NICU, valid maternal depressive or anxiety symptom measures at pre- and postintervention, and publication in a peer-reviewed journal in English.
Data extraction was conducted independently by 2 coders.
Twelve studies met inclusion criteria for qualitative review; 2 were excluded from quantitative analyses for high risk of bias. Fixed- and random-effects models, with 7 eligible studies assessing depressive symptoms, indicated an effect of -0.16 (95% confidence interval [CI], -0.32 to -0.002; < .05) and, with 8 studies assessing anxiety symptoms, indicated an effect of -0.12 (95% CI, -0.29 to 0.05; = .17). The subset of interventions using cognitive behavioral therapy significantly reduced depressive symptoms (effect, -0.44; 95% CI, -0.77 to -0.11; = .01).
The small number and methodological shortcomings of studies limit conclusions regarding intervention effects.
Combined intervention effects significantly reduced maternal depressive but not anxiety symptoms. The evidence is strongest for the impact of cognitive behavioral therapy interventions on maternal depressive symptoms.
婴儿在新生儿重症监护病房（NICU）接受治疗的父母患抑郁和焦虑症的风险很高，这对育儿和婴儿发育有负面影响。
我们对基于新生儿重症监护病房的干预措施进行了系统评价和荟萃分析，以减少产妇的抑郁或焦虑症状。
在 PubMed、Embase、PsychInfo、Cochrane 和 CINAHL 中搜索相关研究。从选定的研究中审查了参考文献列表。
纳入标准包括随机对照设计、在 NICU 中进行的以父母为重点的干预措施、在干预前后使用有效的产妇抑郁或焦虑症状测量方法，以及以英文发表在同行评议期刊上的研究。
由 2 名编码员独立进行数据提取。
12 项研究符合定性综述的纳入标准；2 项因偏倚风险高而被排除在定量分析之外。采用固定效应和随机效应模型，对 7 项评估抑郁症状的研究进行分析，结果表明干预的效果为-0.16（95%置信区间，-0.32 至-0.002；<0.05），对 8 项评估焦虑症状的研究进行分析，结果表明干预的效果为-0.12（95%置信区间，-0.29 至 0.05；=0.17）。使用认知行为疗法的干预措施亚组显著降低了抑郁症状（效果，-0.44；95%置信区间，-0.77 至-0.11；=0.01）。
研究数量少且方法学上的缺陷限制了对干预效果的结论。
综合干预效果显著降低了产妇的抑郁症状，但对焦虑症状没有影响。认知行为疗法干预对产妇抑郁症状的影响证据最强。
