Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
BMJ Open. 2022 May 18;12(5):e051426. doi: 10.1136/bmjopen-2021-051426.
To assess the evidence of the association between exposure to intimate partner violence (IPV) and postpartum depression. IPV during pregnancy can have immediate and long-term physical and mental health consequences for the family. Therefore, it has been hypothesised that IPV may affect the risk of developing postpartum depression.
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Global Health Library, Scopus and Google scholar were searched for published studies without restrictions on language, time or study design (up to May 2020). Studies were included if they assessed postpartum depression using the Edinburg Postnatal Depression Scale (cut-off≥10), among women who had been exposed to IPV (emotional, physical and/or sexual abuse). The quality of studies was judged according to the Newcastle-Ottawa scale.
A total of 33 studies were included in the review (participants n=131 131). The majority of studies found an association between exposure to IPV and the development of signs of postpartum depression. Overall, studies measured both exposure and outcome in various ways and controlled for a vast number of different confounders. Thirty percent of the studies were set in low-income and lower-middle-income countries while the rest were set in upper-middle-income and high-income countries and the association did not differ across settings. Among the studies reporting adjusted OR (aOR) (n=26), the significant aOR ranged between 1.18 and 6.87 (95% CI 1.12 to 11.78). The majority of the studies were judged as 'good quality' (n=20/33).
We found evidence of an association between exposure to IPV and the development of signs of postpartum depression. Meta-analysis or individual patient data meta-analysis is required to quantify the magnitude of the association between IPV and postpartum depression.
CRD42020209435.
评估亲密伴侣暴力（IPV）暴露与产后抑郁症之间关联的证据。怀孕期间的 IPV 会对家庭的身心健康产生直接和长期的影响。因此，有人假设 IPV 可能会影响产后抑郁症的发病风险。
根据系统评价和荟萃分析的首选报告项目指南进行系统评价。在没有语言、时间或研究设计限制的情况下，对 PubMed、Embase、全球卫生图书馆、Scopus 和 Google Scholar 进行了搜索（截至 2020 年 5 月）。如果研究使用爱丁堡产后抑郁量表（截断值≥10）评估产后抑郁症，且研究对象为曾遭受过 IPV（情感、身体和/或性虐待）的女性，则纳入研究。根据纽卡斯尔-渥太华量表来判断研究的质量。
共有 33 项研究纳入了综述（参与者 n=131131）。大多数研究发现 IPV 暴露与产后抑郁症状的发生之间存在关联。总体而言，研究以各种方式测量了暴露和结果，并控制了大量不同的混杂因素。30%的研究在低收入和中下收入国家进行，其余研究在中上收入和高收入国家进行，且这种关联在不同的研究环境中并无差异。在报告调整后的比值比（aOR）的研究中（n=26），有意义的 aOR 范围在 1.18 到 6.87（95%CI 1.12 到 11.78）之间。大多数研究被评为“高质量”（n=20/33）。
我们发现 IPV 暴露与产后抑郁症状的发生之间存在关联的证据。需要进行荟萃分析或个体患者数据荟萃分析来量化 IPV 和产后抑郁症之间关联的幅度。
PROSPERO 注册号：CRD42020209435。
