Malouf Reem, Harrison Sian, Burton Hollie A L, Gale Chris, Stein Alan, Franck Linda S, Alderdice Fiona
Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, Chelsea and Westminster campus, 369 Fulham Road, London, SW10 9NH.
EClinicalMedicine. 2021 Dec 21;43:101233. doi: 10.1016/j.eclinm.2021.101233. eCollection 2022 Jan.
Parents of babies admitted to neonatal units (NNU) are exposed to a range of potentially distressing experiences, which can lead to mental health symptoms such as increased anxiety and post-traumatic stress (PTS). This review aimed to describe how anxiety and PTS are defined and assessed, and to estimate anxiety and PTS prevalence among parents of babies admitted to NNU.
Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health literature were searched to identify studies published prior to April 14, 2021. Included studies were assessed using Hoy risk of bias tool. A random-effects model was used to estimate pooled prevalence with 95% CIs. Potential sources of variation were investigated using subgroup analyses and meta-regression. The review is registered with PROSPERO (CRD42020162935).
Fifty six studies involving 6,036 parents met the review criteria; 21 studies assessed anxiety, 35 assessed PTS, and 8 assessed both. The pooled prevalence of anxiety was 41.9% (95%CI:30.9, 53.0) and the pooled prevalence of PTS was 39.9% (95%CI:30.8, 48.9) among parents up to one month after the birth. Anxiety prevalence decreased to 26.3% (95%CI:10.1, 42.5) and PTS prevalence to 24.5% (95%CI:17.4, 31.6) between one month and one year after birth. More than one year after birth PTS prevalence remained high 27.1% (95%CI:20.7, 33.6). Data on anxiety at this time point were limited. There was high heterogeneity between studies and some evidence from subgroup and meta-regression analyses that study characteristics contributed to the variation in prevalence estimates.
The prevalence of anxiety and PTS was high among parents of babies admitted to NNU. The rates declined over time, although they remained higher than population prevalence estimates for women in the perinatal period. Implementing routine screening would enable early diagnosis and effective intervention.
This research is funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
入住新生儿重症监护病房（NNU）的婴儿的父母会经历一系列潜在的痛苦经历，这可能导致心理健康症状，如焦虑增加和创伤后应激反应（PTS）。本综述旨在描述焦虑和PTS是如何定义和评估的，并估计入住NNU的婴儿父母中焦虑和PTS的患病率。
检索了Medline、Embase、PsychoINFO、护理及相关健康文献累积索引，以确定2021年4月14日前发表的研究。使用Hoy偏倚风险工具对纳入的研究进行评估。采用随机效应模型估计合并患病率及95%置信区间。使用亚组分析和Meta回归研究潜在的变异来源。该综述已在PROSPERO（CRD42020162935）注册。
56项涉及6036名父母的研究符合综述标准；21项研究评估了焦虑，35项评估了PTS，8项同时评估了两者。在婴儿出生后一个月内，父母中焦虑的合并患病率为41.9%（95%置信区间：30.9，53.0），PTS的合并患病率为39.9%（95%置信区间：30.8，48.9）。在出生后1个月至1年之间，焦虑患病率降至26.3%（95%置信区间：10.1，42.5），PTS患病率降至24.5%（95%置信区间：17.4，31.6）。出生一年多后，PTS患病率仍然很高，为27.1%（95%置信区间：20.7，33.6）。此时关于焦虑的数据有限。研究之间存在高度异质性，亚组分析和Meta回归分析的一些证据表明，研究特征导致了患病率估计值的差异。
入住NNU的婴儿父母中焦虑和PTS的患病率很高。尽管这些比率仍高于围产期女性的总体患病率估计值，但随着时间的推移有所下降。实施常规筛查将有助于早期诊断和有效干预。
本研究由英国国家卫生研究院（NIHR）政策研究计划资助，通过孕产妇和新生儿健康与护理政策研究单位进行，项目编号为PR-PRU-1217-21202。所表达的观点仅代表作者个人，不一定代表NIHR或卫生与社会保健部的观点。
