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意外怀孕与产后抑郁:队列研究和病例对照研究的荟萃分析。

Unintended pregnancy and postpartum depression: A meta-analysis of cohort and case-control studies.

机构信息

Department of Humanistic Nursing, School of Nursing, Changsha Medical University, Hunan, China.

Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China.

出版信息

J Psychosom Res. 2020 Nov;138:110259. doi: 10.1016/j.jpsychores.2020.110259. Epub 2020 Sep 23.

Abstract

OBJECTIVE

The majority of original studies showed that unintended pregnancy is related to adverse obstetric outcomes, however, up to now, the influence of unintended pregnancy on the risk of developing postpartum depression (PPD) remains unclear. This study aimed to assess the association between unintended pregnancy and the risk of developing PPD by conducting a meta-analysis of cohort and case-control studies.

METHODS

PubMed, Web of Science, Embase, and Cochrane Library were searched up to December 31, 2019 to identify relevant studies evaluating the association between unintended pregnancy and PPD. Meta-analysis was performed using RevMan software and Stata software. Potential heterogeneity source was explored by subgroup and sensitivity analyses, and potential publication bias was tested using Begg's funnel plots and Begg's linear regression test.

RESULTS

A total of thirty studies involving 65,454 participants were included in our meta-analysis. Overall, women who get pregnant unintendedly compared with those who are intending to be pregnant were at a significantly higher risk of developing PPD (odds ratio [OR] = 1.53; 95% confidence interval [CI]: 1.35-1.74; P < 0.00001).

CONCLUSIONS

Unintended pregnancy is significantly associated with the risk of developing PPD. These findings highlight the necessity of screening for pregnancy intention and integrating family planning and personalized mental health services into primary healthcare to promote maternal mental health.

摘要

目的

大多数原始研究表明,意外怀孕与不良产科结局有关,然而,到目前为止,意外怀孕对产后抑郁症(PPD)发病风险的影响尚不清楚。本研究旨在通过对队列研究和病例对照研究进行荟萃分析,评估意外怀孕与 PPD 发病风险之间的关联。

方法

检索 PubMed、Web of Science、Embase 和 Cochrane Library 数据库,检索时间截至 2019 年 12 月 31 日,以确定评估意外怀孕与 PPD 之间关联的相关研究。使用 RevMan 软件和 Stata 软件进行荟萃分析。通过亚组和敏感性分析探讨潜在的异质性来源,并使用 Begg 漏斗图和 Begg 线性回归检验测试潜在的发表偏倚。

结果

本荟萃分析共纳入 30 项研究,涉及 65454 名参与者。总体而言,与计划怀孕的女性相比,意外怀孕的女性发生 PPD 的风险显著更高(比值比 [OR] = 1.53;95%置信区间 [CI]:1.35-1.74;P < 0.00001)。

结论

意外怀孕与 PPD 的发病风险显著相关。这些发现强调了筛查怀孕意向的必要性,并将计划生育和个性化心理健康服务纳入初级保健,以促进产妇心理健康。

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