Anderson Fraser M, Hatch Stephani L, Comacchio Carla, Howard Louise M
Section of Women's Mental Health, IOPPN, King's College London, Box P031, David Goldberg Centre, 16 De Crespigny Park, London, SE5 8AF, UK.
Department of Psychological Medicine, IOPPN, King's College London, London, UK.
Arch Womens Ment Health. 2017 Jun;20(3):449-462. doi: 10.1007/s00737-017-0723-z. Epub 2017 Apr 8.
This study was conducted in order to evaluate the prevalence and risk of mental disorders in the perinatal period among migrant women. Six databases (including MEDLINE) were searched from inception to October 19th, 2015, in addition to citation tracking. Studies were eligible if mental disorders were assessed with validated tools during pregnancy and up to 1 year postpartum among women born outside of the study country. Of 3241 abstracts screened, 53 met the inclusion criteria for the review. Only three studies investigated a mental disorder other than depression. Unadjusted odds ratios were pooled using random effects meta-analysis for elevated depression symptoms during pregnancy (n = 12) and the postpartum (n = 24), stratified by study country due to heterogeneity. Studies from Canada found an increased risk for antenatal (OR = 1.86, 95% CIs 1.32-2.62) and postnatal elevated depression symptoms (OR = 1.98, 95% CIs 1.57-2.49) associated with migrant status. Studies from the USA found a decreased risk of antenatal elevated depression symptoms (OR = 0.71, 95% CIs 0.51-0.99), and studies from the USA and Australia found no association between migrant status and postnatal elevated depression symptoms. Low social support, minority ethnicity, low socioeconomic status, lack of proficiency in host country language and refugee or asylum-seeking status all put migrant populations at increased risk of perinatal mental disorders.
本研究旨在评估流动妇女围产期精神障碍的患病率及风险。除了引文追踪外，还检索了从建库至2015年10月19日的六个数据库（包括MEDLINE）。如果在孕期及产后1年内，使用经过验证的工具对出生于研究国家以外的妇女进行精神障碍评估，则这些研究符合纳入标准。在筛选的3241篇摘要中，有53篇符合综述的纳入标准。只有三项研究调查了除抑郁症以外的精神障碍。对于孕期（n = 12）和产后（n = 24）抑郁症状加重的情况，由于存在异质性，按研究国家分层，使用随机效应荟萃分析汇总未调整的比值比。来自加拿大的研究发现，流动状态与产前（OR = 1.86，95%CI 1.32 - 2.62）及产后抑郁症状加重（OR = 1.98，95%CI 1.57 - 2.49）风险增加相关。来自美国的研究发现产前抑郁症状加重的风险降低（OR = 0.71，95%CI 0.51 - 0.99），而来自美国和澳大利亚的研究发现流动状态与产后抑郁症状加重之间无关联。社会支持低、少数族裔、社会经济地位低、东道国语言不熟练以及难民或寻求庇护者身份，均使流动人群患围产期精神障碍的风险增加。
