Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
J Affect Disord. 2022 Jan 15;297:118-129. doi: 10.1016/j.jad.2021.10.026. Epub 2021 Oct 20.
Perinatal loss can pose a significant risk to maternal mental health. There is limited data on the strength of association between perinatal loss and subsequent common mental health disorders (CMHD) such as anxiety, depression and post-traumatic symptoms (PTS). A systematic review and meta-analysis identified studies with control groups, published between January 1995 and March 2020 reporting validated mental health outcomes following perinatal loss. We identified 29 studies from 17 countries, representing a perinatal loss sample (n = 31,072) and a control group of women not experiencing loss (n = 1,261,517). We compared the likelihood of increased CMHD in both groups. Random-effects modelling on suggested that compared to controls, perinatal loss was associated with increased risk of depressive (RR = 2.14, 95% CI = 1.73-2.66, p < 0.001, k = 22) and anxiety disorders (RR = 1.75, 95% CI = 1.27-2.42, p < 0.001, k = 9). Compared to controls, Perinatal loss was also associated with increased depression (SMD = 0.34, 95% CI = 0.20-0.48, p < 0.001, k = 12) and anxiety scores (SMD = 0.35, 95% CI = 0.12-0.58, p < 0.003, k = 10). There were no significant effects for post-traumatic stress (PTS) outcomes (k = 3). Our findings confirm that anxiety and depression levels following perinatal loss are significantly elevated compared to "no loss" controls (live-births, non pregnant from community, or difficult live births). Elevated depression and anxiety rates were also reported for those who experienced loss during later stages of pregnancy. Assessing mental health following loss is a maternal health priority.
围产期损失可能会对产妇的心理健康造成重大风险。目前，关于围产期损失与随后常见的心理健康障碍（如焦虑、抑郁和创伤后应激症状（PTS））之间关联强度的数据有限。一项系统评价和荟萃分析确定了具有对照组的研究，这些研究于 1995 年 1 月至 2020 年 3 月期间发表，报告了围产期损失后经过验证的心理健康结果。我们从 17 个国家中确定了 29 项研究，这些研究代表了围产期损失样本（n=31072）和未经历损失的对照组女性（n=1261517）。我们比较了两组中常见心理健康障碍（CMHD）发生率的差异。随机效应模型表明，与对照组相比，围产期损失与抑郁障碍（RR=2.14，95%CI=1.73-2.66，p<0.001，k=22）和焦虑障碍（RR=1.75，95%CI=1.27-2.42，p<0.001，k=9）的风险增加相关。与对照组相比，围产期损失也与抑郁（SMD=0.34，95%CI=0.20-0.48，p<0.001，k=12）和焦虑评分（SMD=0.35，95%CI=0.12-0.58，p<0.003，k=10）的增加相关。创伤后应激（PTS）结局（k=3）无显著影响。我们的研究结果证实，与“无损失”对照组（活产、社区中未怀孕者或难产）相比，围产期损失后焦虑和抑郁水平显著升高。在妊娠后期经历过损失的人群中，也报告了较高的抑郁和焦虑发生率。评估损失后的心理健康是产妇健康的重点。
