Doyle Frances Lee, Klein Louis
School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
Front Glob Womens Health. 2020 Oct 22;1:577273. doi: 10.3389/fgwh.2020.577273. eCollection 2020.
The disruption of normal life due to the COVID-19 pandemic is expected to exacerbate extant risk factors for mental health problems. This may be particularly true for women who give birth during the crisis, especially those at risk for postnatal depression. Maternal postnatal depression has been identified as a public health issue with profound impacts on maternal and child well-being. Evidence from previous crises (e.g., earthquakes, terrorist attacks) has shown that crises significantly impact maternal mental health and some perinatal health outcomes. The aims of this paper were therefore to conduct a review to identify the established risk factors for maternal postnatal depression, and generate evidence-based hypotheses about whether the COVID-19 crisis would likely increase or decrease postnatal depression rates based on the identified risk factors. Several databases were searched during May-June 2020 for review papers (i.e., systematic reviews, meta-analyses, qualitative syntheses) using the following keywords: Depression, perinatal, postnatal, postpartum, systematic, review, predictors. Risk factors were extracted in conjunction with indicators for their strength of evidence (i.e., effect sizes, qualitative coding). Risk factors were critically evaluated in relation to their susceptibility to the impacts of the COVID-19 crisis. It was hypothesized that several health policies that were necessary to reduce the spread of COVID-19 (e.g., required restrictions) may be simultaneously impacting a range of these known risk factors and placing a larger number of women at heightened risk for postnatal depression. For instance, factors at a strong risk of being exacerbated include: Perceived low social support; exposure to traumatic events during or prior to pregnancy; significant life events occurring during pregnancy; and high stress associated with care of children. Future research and policy implications are discussed, including how policy makers could attempt to ameliorate the identified risk factors for postnatal depression following the current COVID-19 pandemic.
由于新冠疫情大流行导致的正常生活中断，预计会加剧现存的心理健康问题风险因素。对于在危机期间分娩的女性，尤其是那些有产后抑郁症风险的女性来说，可能更是如此。产妇产后抑郁症已被认定为一个对母婴健康有深远影响的公共卫生问题。以往危机（如地震、恐怖袭击）的证据表明，危机对产妇心理健康和一些围产期健康结果有重大影响。因此，本文的目的是进行一项综述，以确定已明确的产妇产后抑郁症风险因素，并根据所确定的风险因素，提出基于证据的假设，即新冠疫情危机是否可能增加或降低产后抑郁症的发病率。2020年5月至6月期间，使用以下关键词在多个数据库中搜索综述论文（即系统评价、荟萃分析、定性综合分析）：抑郁症、围产期、产后、产后、系统、综述、预测因素。结合证据强度指标（即效应量、定性编码）提取风险因素。对风险因素与它们对新冠疫情危机影响的易感性进行了严格评估。据推测，一些为减少新冠病毒传播所必需的卫生政策（如强制限制措施）可能同时影响一系列这些已知的风险因素，使更多女性面临产后抑郁症的高风险。例如，极有可能加剧的因素包括：感知到的社会支持不足；孕期或孕前遭受创伤性事件；孕期发生重大生活事件；以及与照顾孩子相关的高压力。文中讨论了未来的研究和政策影响，包括政策制定者如何在当前新冠疫情大流行之后尝试改善已确定的产后抑郁症风险因素。
