Telethon Kids Institute, The University of Western Australia, P.O. Box 855, West Perth, WA, 6872, Australia.
Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia.
Arch Womens Ment Health. 2021 Aug;24(4):543-555. doi: 10.1007/s00737-020-01099-9. Epub 2021 Jan 2.
Evidence about the association between maternal mental health disorders and stillbirth and infant mortality is limited and conflicting. We aimed to examine whether maternal prenatal mental health disorders are associated with stillbirth and/or infant mortality. MEDLINE, Embase, PsycINFO, and Scopus were searched for studies examining the association of any maternal prenatal (occurring before or during pregnancy) mental health disorder(s) and stillbirth or infant mortality. A random-effects meta-analysis was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). The between-study heterogeneity was quantified using the I statistic. Subgroup analyses were performed to identify the source of heterogeneity. Of 4487 records identified, 28 met our inclusion criteria with 27 contributing to the meta-analyses. Over 60% of studies examined stillbirth and 54% of them evaluated neonatal or infant mortality. Thirteen studies investigated the association between maternal depression and anxiety and stillbirth/infant mortality, pooled OR, 1.42 (95% CI, 1.16-1.73; I, 76.7%). Another 13 studies evaluated the association between severe maternal mental illness and stillbirth/infant mortality, pooled OR, 1.47 (95% CI, 1.28-1.68; I, 62.3%). We found similar results for the association of any maternal mental health disorders and stillbirth/infant mortality (OR, 1.59; 95% CI, 1.43-1.77) and in subgroup analyses according to types of fetal/infant mortality. We found no significant evidence of publication bias. Maternal prenatal mental health disorders appear to be associated with a moderate increase in the risk of stillbirth and infant mortality, although the mechanisms are unclear. Efforts to prevent and treat these disorders may reduce the scale of stillbirth/infant deaths.
关于产妇心理健康障碍与死产和婴儿死亡之间关联的证据有限且相互矛盾。我们旨在研究产妇产前心理健康障碍是否与死产和/或婴儿死亡有关。我们检索了 MEDLINE、Embase、PsycINFO 和 Scopus，以查找研究任何产妇产前（发生在怀孕前或怀孕期间）心理健康障碍与死产或婴儿死亡之间关联的研究。使用随机效应荟萃分析计算合并优势比（OR）及其 95%置信区间（CI）。使用 I 统计量来量化研究间的异质性。进行了亚组分析以确定异质性的来源。在 4487 条记录中，有 28 条符合我们的纳入标准，其中 27 条为荟萃分析提供了数据。超过 60%的研究调查了死产，54%的研究评估了新生儿或婴儿死亡率。有 13 项研究调查了产妇抑郁和焦虑与死产/婴儿死亡之间的关联，合并 OR 为 1.42（95%CI，1.16-1.73；I²，76.7%）。另有 13 项研究评估了严重产妇精神疾病与死产/婴儿死亡之间的关联，合并 OR 为 1.47（95%CI，1.28-1.68；I²，62.3%）。我们发现，任何产妇心理健康障碍与死产/婴儿死亡之间的关联也存在类似的结果（OR，1.59；95%CI，1.43-1.77），并且根据胎儿/婴儿死亡类型进行的亚组分析也存在类似结果。我们没有发现发表偏倚的显著证据。产妇产前心理健康障碍似乎与死产和婴儿死亡的风险增加中度相关，尽管其机制尚不清楚。努力预防和治疗这些障碍可能会降低死产/婴儿死亡的规模。
