Atif Maria, Halaki Mark, Raynes-Greenow Camille, Chow Chin-Moi
Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Birth. 2021 Jun;48(2):149-163. doi: 10.1111/birt.12535. Epub 2021 Feb 12.
To estimate the prevalence and associated risk factors of perinatal depression in Pakistan.
We conducted a systematic search of Medline, PsycINFO, CINAHL, EMBASE, and Global health, up through May 31, 2019. Studies reporting on the prevalence of perinatal depression in Pakistan with or without associated risks factors were included.
Forty-three studies reporting data from 17 544 women met the eligibility criteria and were included. Overall, the pooled prevalence of antenatal depression was 37% (95% CI: 30-44), while that of postnatal depression was 30% (95% CI: 25-36). The prevalence of perinatal depression in women residing in urban areas and those living in rural settings was not significantly different. The most frequently reported risk factors for antenatal depression were intimate partner violence and poor relationship with spouse, and that reported for postnatal depression was low-income level. An unintended pregnancy was significantly associated with perinatal depression in Pakistan.
We identified variability in prevalence rate of perinatal depression in Pakistan. It is difficult to gauge the true magnitude of this problem potentially due to differing risk factors between the antenatal and postnatal periods and the lack of uniformity of data collection protocols and procedures. The high prevalence rates of 30%-37% compared to global estimates suggest policy makers and stakeholders should direct additional resources toward improving perinatal mental health in Pakistan.
评估巴基斯坦围产期抑郁症的患病率及相关危险因素。
我们对截至2019年5月31日的医学期刊数据库（Medline）、心理学文摘数据库（PsycINFO）、护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（EMBASE）和全球健康数据库进行了系统检索。纳入了报告巴基斯坦围产期抑郁症患病率及有无相关危险因素的研究。
43项报告17544名女性数据的研究符合纳入标准并被纳入。总体而言，产前抑郁症的合并患病率为37%（95%置信区间：30-44），产后抑郁症的合并患病率为30%（95%置信区间：25-36）。城市地区和农村地区女性围产期抑郁症的患病率无显著差异。产前抑郁症最常报告的危险因素是亲密伴侣暴力和与配偶关系不佳，产后抑郁症最常报告的危险因素是低收入水平。在巴基斯坦，意外怀孕与围产期抑郁症显著相关。
我们发现巴基斯坦围产期抑郁症患病率存在差异。由于产前和产后时期的危险因素不同以及数据收集方案和程序缺乏统一性，难以衡量这一问题的真实严重程度。与全球估计相比，30%-37%的高患病率表明政策制定者和利益相关者应将更多资源用于改善巴基斯坦的围产期心理健康。
