Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, the Edward G. Miner Library, Institute for Innovative Education, the Department of Public Health Sciences, the Department of Obstetrics & Gynecology, and the Department of Psychiatry, University of Rochester Medical Center, and the School of Medicine and Dentistry, University of Rochester, Rochester, New York.
Obstet Gynecol. 2021 May 1;137(5):881-891. doi: 10.1097/AOG.0000000000004335.
To systematically review the prevalence of antenatal depression and anxiety in women hospitalized in an antepartum unit for obstetric complications.
We searched PubMed, EMBASE, CINAHL, PsycINFO, and ClinicalTrials.gov for English-language articles published from database inception through March 2020.
We included cross-sectional, cohort, case-control, quasi-experimental, and randomized controlled studies from any country that reported the proportion of pregnant women with an elevated depression or anxiety screening scale or diagnostic interview during antepartum hospitalization of any duration and at any gestational age.
TABULATION, INTEGRATION, AND RESULTS: We identified 8,799 articles and reviewed 79, 39 of which were included in a systematic review and 18 in meta-analysis of the primary outcome. Two raters independently assessed quality of individual studies using a 14-question tool. A random effects meta-analysis model was used to estimate prevalence and 95% CI of depression or anxiety. Heterogeneity was examined with the I2 test, and funnel plots were used to assess publication bias. After meta-analysis, the estimated prevalence of depression was 34% (95% CI 27-41%) and of anxiety 29% (95% CI 16-43%). There was expected substantial clinical and methodologic heterogeneity between studies that persisted even after planned a priori subgroup analyses and meta-regression. Even so, the direction of effect was consistent across studies. No publication bias was found.
The current meta-analysis suggests that one in three women hospitalized during pregnancy for obstetric complications report clinical levels of depression or anxiety symptoms, twice the reported prevalence of antenatal depression or anxiety in the general obstetric population.
PROSPERO, CRD42020172111.
系统回顾因产科并发症住院的产前病房孕妇产前抑郁和焦虑的患病率。
我们检索了 PubMed、EMBASE、CINAHL、PsycINFO 和 ClinicalTrials.gov，以获取自数据库建立至 2020 年 3 月发表的英文文章。
我们纳入了来自任何国家的横断面研究、队列研究、病例对照研究、准实验研究和随机对照研究，这些研究报告了在任何产前住院期间和任何孕龄段，使用升高的抑郁或焦虑筛查量表或诊断性访谈的孕妇比例。
我们共确定了 8799 篇文章，其中 79 篇文章进行了系统综述，39 篇文章进行了meta 分析。两名评估员使用一个 14 个问题的工具独立评估了个体研究的质量。使用随机效应 meta 分析模型估计了抑郁或焦虑的患病率及其 95%置信区间。用 I2 检验来检验异质性，并使用漏斗图来评估发表偏倚。meta 分析后，抑郁的估计患病率为 34%（95%CI 27-41%），焦虑的估计患病率为 29%（95%CI 16-43%）。即使在计划进行预先指定的亚组分析和 meta 回归后，研究之间仍存在预期的较大临床和方法学异质性。即便如此，研究之间的效应方向仍一致。未发现发表偏倚。
当前的 meta 分析表明，因产科并发症住院的孕妇中，每 3 人就有 1 人报告有临床水平的抑郁或焦虑症状，这是普通产科人群中产前抑郁或焦虑报告患病率的两倍。
PROSPERO，CRD42020172111。
