Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
J Affect Disord. 2021 Aug 1;291:32-38. doi: 10.1016/j.jad.2021.05.002. Epub 2021 May 8.
Background The relationship between maternal psychological stress during pregnancy and risk of congenital heart disease (CHD) in offspring is still unclear. We conducted a meta-analysis to quantitatively evaluate the association. Methods Literature search was performed through May 2020 using PubMed and Web of Science databases. Observational studies evaluating the associations of maternal psychological stress including stress, stress life events, anxiety and depression with CHD risk in offspring were eligible for the study. Results Ten case-control studies with 16,382 CHD cases and 1,812,999 non-CHD controls were included in the meta-analysis. Four studies assessed the association between maternal stress during pregnancy and CHD risk in offspring. The pooled odds ratio (OR) was 2.11 (95%CI: 1.62, 2.74) for those mothers with stress during pregnancy. Six studies assessed the association between maternal stressful life events during pregnancy and CHD risk in offspring. The pooled OR was 1.86 (95%CI: 1.29, 2.68) for those mothers exposed to stressful life events during pregnancy. Maternal anxiety and depression may not be associated with CHD risk in offspring. The pooled ORs were 1.42 (95%CI: 0.53, 3.77) and 2.10 (95%CI: 0.46, 9.59) for the maternal anxiety and depression during pregnancy, respectively. Limitations Residual confounding, heterogeneity and publication bias may exist, which may limit the interpretation of the results. Conclusion Maternal stress and stressful life events during pregnancy may be associated with higher risk of CHD in offspring, but such association was not observed for other mental health exposures such as anxiety and depression.
孕妇心理压力与子女先天性心脏病（CHD）风险之间的关系尚不清楚。我们进行了一项荟萃分析，以定量评估这种关联。
通过PubMed 和 Web of Science 数据库检索 2020 年 5 月前发表的评估包括压力、生活应激事件、焦虑和抑郁在内的孕妇心理压力与子女 CHD 风险关联的观察性研究。
纳入了 10 项病例对照研究，共有 16382 例 CHD 病例和 1812999 例非 CHD 对照。4 项研究评估了孕妇孕期压力与子女 CHD 风险之间的关联。合并的比值比（OR）为 2.11（95%CI：1.62，2.74）。6 项研究评估了孕妇孕期生活应激事件与子女 CHD 风险之间的关联。合并的 OR 为 1.86（95%CI：1.29，2.68）。孕妇焦虑和抑郁可能与子女 CHD 风险无关。合并的 OR 分别为 1.42（95%CI：0.53，3.77）和 2.10（95%CI：0.46，9.59）。
可能存在残余混杂、异质性和发表偏倚，这可能限制了对结果的解释。
孕妇孕期压力和生活应激事件可能与子女 CHD 风险增加相关，但其他心理健康暴露（如焦虑和抑郁）与 CHD 风险之间未见关联。
