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预测青少年母亲产后抑郁:风险的系统评价

Predicting postpartum depression among adolescent mothers: A systematic review of risk.

机构信息

School of Health in Social Science, Clinical Psychology, University of Edinburgh, United Kingdom.

School of Health in Social Science, Clinical Psychology, University of Edinburgh, United Kingdom.

出版信息

J Affect Disord. 2019 Mar 1;246:873-885. doi: 10.1016/j.jad.2018.12.041. Epub 2018 Dec 18.

Abstract

BACKGROUND/AIMS: Postpartum depression (PPD) is a debilitating illness with negative consequences for affected mothers and their children (e.g., poor maternal-infant attachment, deficits in children's social, emotional, and cognitive development). While it is suggested that adolescent mothers are at increased risk of PPD, there is a paucity of research exploring factors that place adolescent mothers at risk. This systematic review aims to identify risk factors associated with adolescent PPD and appraise the quality of this evidence-base.

METHOD

A systematic review was conducted in May of 2018, using PsycINFO, EMBASE, MEDLINE, ASSIA, CINAHL, MIDIRS, and ProQuest Dissertations and Theses Global database, following PRISMA guidelines. Inclusion criteria included studies from developed countries; published after 1992; using a validated measure of PPD; with onset of illness within 12 months of childbirth, but which had persisted past two-weeks postpartum; adolescent mothers < 20 years of age; and risk factor(s) that occurred prior to birth.

RESULTS

Fourteen studies were included, ranging from weak-to-strong in quality. Results suggest several risk factors implicated in the onset of adolescent PPD, including prior depression, lack of familial social support, and socio-economic hardship.

CONCLUSIONS/LIMITATIONS: Awareness of risk factors for healthcare professionals working with pregnant adolescents is of high importance to better facilitate early identification and to provide support for adolescents at risk. Future research ought to consider employing prospective longitudinal designs, along with clearly defined, timely and validated measurements of risk factors and PPD. Limitations include only studies published in English and low agreement on the included studies selection bias.

摘要

背景/目的:产后抑郁症(PPD)是一种使人虚弱的疾病,会对患病母亲及其子女产生负面影响(例如,母婴依恋不良、儿童社会、情感和认知发展缺陷)。虽然有研究表明,青少年母亲患 PPD 的风险增加,但对于使青少年母亲面临风险的因素的研究却很少。本系统评价旨在确定与青少年 PPD 相关的风险因素,并评估该证据基础的质量。

方法

2018 年 5 月,我们按照 PRISMA 指南,使用 PsycINFO、EMBASE、MEDLINE、ASSIA、CINAHL、MIDIRS 和 ProQuest Dissertations and Theses Global 数据库进行了系统评价。纳入标准包括来自发达国家的研究;发表于 1992 年以后;使用经过验证的 PPD 测量方法;疾病发作在分娩后 12 个月内,但持续时间超过两周;青少年母亲年龄小于 20 岁;以及在分娩前发生的风险因素。

结果

共纳入 14 项研究,质量从弱到强不等。结果表明,有几个风险因素与青少年 PPD 的发病有关,包括先前的抑郁、缺乏家庭社会支持以及社会经济困难。

结论/局限性:了解与妊娠青少年合作的医疗保健专业人员相关的风险因素非常重要,以便更好地促进早期识别,并为有风险的青少年提供支持。未来的研究应该考虑采用前瞻性纵向设计,以及明确、及时和有效的风险因素和 PPD 测量方法。局限性包括仅研究发表在英语中,以及纳入研究的选择偏倚存在低一致性。

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