The University of Queensland, School of Public Health, Herston, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.
The University of Queensland, School of Public Health, Herston, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, USA.
J Affect Disord. 2017 Sep;219:86-92. doi: 10.1016/j.jad.2017.05.003. Epub 2017 May 8.
Major Depressive Disorder (MDD) is a leading cause of the disease burden for women of childbearing age, but the burden of MDD attributable to perinatal depression is not yet known. There has been little effort to date to systematically review available literature and produce global estimates of prevalence and incidence of perinatal depression. Enhanced understanding will help to guide resource allocation for screening and treatment.
A systematic literature review using the databases PsycINFO and PubMed returned 140 usable prevalence estimates from 96 studies. A random-effects meta-regression was performed to determine sources of heterogeneity in prevalence estimates between studies and to guide a subsequent random-effects meta-analysis.
The meta-regression explained 31.1% of the variance in prevalence reported between studies. Adjusting for the effects of all other variables in the model, prevalence derived using symptom scales was significantly higher than prevalence derived using diagnostic instruments (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.3-2.0). Additionally, prevalence was significantly higher in women from low and middle income countries compared to women from high income countries (OR 1.8, 95% CI 1.4-2.2). The overall pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4-12.5). There were insufficient data to calculate pooled incidence.
Studies in low income countries were especially scarce in this review, demonstrating a need for more epidemiological research in those regions.
Perinatal depression appears to impose a higher burden on women in low- and middle-income countries. This review contributes significantly to the epidemiological literature on the disorder.
重度抑郁症（MDD）是导致育龄期女性疾病负担的主要原因，但围产期抑郁症的负担尚不清楚。迄今为止，很少有努力系统地审查现有文献并生成围产期抑郁症的患病率和发病率的全球估计值。增强理解将有助于指导筛查和治疗的资源分配。
使用数据库 PsycINFO 和 PubMed 进行系统文献回顾，从 96 项研究中获得了 140 个可用的患病率估计值。进行了随机效应荟萃回归，以确定研究之间患病率估计值差异的来源，并指导随后的随机效应荟萃分析。
荟萃回归解释了研究之间报告的患病率差异的 31.1%。在调整模型中所有其他变量的影响后，使用症状量表得出的患病率明显高于使用诊断工具得出的患病率（比值比 [OR] 1.6，95%置信区间 [CI] 1.3-2.0）。此外，与高收入国家的女性相比，来自中低收入国家的女性的患病率明显更高（OR 1.8，95% CI 1.4-2.2）。整个围产期期间，女性的总体患病率为 11.9%（95% CI 11.4-12.5）。没有足够的数据来计算汇总发病率。
本综述中低收入国家的研究尤其稀缺，表明这些地区需要更多的流行病学研究。
围产期抑郁症似乎对中低收入国家的女性造成了更高的负担。本综述对该疾病的流行病学文献做出了重要贡献。
