Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, Queensland, Australia.
Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia.
J Psychiatr Res. 2020 Feb;121:82-90. doi: 10.1016/j.jpsychires.2019.11.010. Epub 2019 Nov 17.
Premenstrual syndrome (PMS) is thought to be a risk factor for postpartum depression (PPD), but results from studies examining the association have been mixed.
To estimate the association between pre-pregnancy history of PMS and development of PPD and evaluate the risk of bias of included evidence.
PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library, CNKI, Wanfang Data, and reference lists of relevant papers were searched.
Observational studies that collected pre-pregnancy history of PMS and measured PPD status between one week and one year after delivery were included.
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effect models were used to calculate pooled odds ratios (ORs) with 95% confidence interval (CI). Small study effect was analysed by funnel plot. Risk of bias was assessed using the Risk of Bias Instrument for Non-Randomized Studies of Exposures (ROBINS-E).
Our meta-analysis included 19 studies. Overall, women with a pre-pregnancy history of PMS had more than double the odds of PPD compared to those without PMS (OR: 2.20, 95% CI: 1.81-2.68). However, the quality of evidence was low: five studies had moderate risk, eleven studies had serious risk, and three studies had critical risk of bias.
Current evidence supports a significant association between history of PMS and development of PPD. Well-designed prospective studies are needed to further investigate this relationship.
经前期综合征（PMS）被认为是产后抑郁症（PPD）的一个风险因素，但研究结果喜忧参半。
评估孕前 PMS 病史与 PPD 发病之间的关联，并评估纳入证据的偏倚风险。
检索了 PubMed、EMBASE、CINAHL、PsycINFO、Cochrane 图书馆、CNKI、万方数据和相关文献的参考文献列表。
纳入了收集孕前 PMS 病史并在产后一周至一年期间测量 PPD 状态的观察性研究。
本研究遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。使用随机效应模型计算合并优势比（OR）及其 95%置信区间（CI）。通过漏斗图分析小样本研究效应。使用非随机暴露研究风险评估工具（ROBINS-E）评估偏倚风险。
本荟萃分析纳入了 19 项研究。总体而言，与没有 PMS 的女性相比，有孕前 PMS 病史的女性患 PPD 的几率高出两倍多（OR：2.20，95%CI：1.81-2.68）。然而，证据质量较低：五项研究存在中度偏倚，十一项研究存在严重偏倚，三项研究存在严重偏倚。
目前的证据支持 PMS 病史与 PPD 发病之间存在显著关联。需要进行设计良好的前瞻性研究来进一步研究这种关系。
