Yonsei University College of Medicine, Seoul, the Republic of Korea.
Department of Psychiatry, Yonsei University College of Medicine, Seoul, the Republic of Korea.
Neurosci Biobehav Rev. 2022 Sep;140:104761. doi: 10.1016/j.neubiorev.2022.104761. Epub 2022 Jul 6.
We performed an umbrella review on environmental risk/protective factors and biomarkers for postpartum depressive symptoms to establish a hierarchy of evidence. We systematically searched PubMed, Embase, and the Cochrane Database of Systematic Reviews from inception until 12 January 2021. We included systematic reviews providing meta-analyses related to our research objectives. Methodological quality was assessed by AMSTAR 2, and the certainty of evidence was evaluated by GRADE. This review was registered in PROSPERO (CRD42021230784). We identified 30 articles, which included 45 environmental risk/protective factors (154,594 cases, 7,302,273 population) and 9 biomarkers (2018 cases, 16,757 population). The credibility of evidence was convincing (class I) for antenatal anxiety (OR 2.49, 1.91-3.25) and psychological violence (OR 1.93, 1.54-2.42); and highly suggestive (class II) for intimate partner violence experience (OR 2.86, 2.12-3.87), intimate partner violence during pregnancy (RR 2.81, 2.11-3.74), smoking during pregnancy (OR 2.39, 1.78-3.2), history of premenstrual syndrome (OR 2.2, 1.81-2.68), any type of violence experience (OR 2.04, 1.72-2.41), primiparity compared to multiparity (RR 1.76, 1.59-1.96), and unintended pregnancy (OR 1.53, 1.35-1.75).
我们对产后抑郁症状的环境风险/保护因素和生物标志物进行了伞式审查,以建立证据等级。我们系统地检索了 PubMed、Embase 和 Cochrane 系统评价数据库,检索时间从建库至 2021 年 1 月 12 日。我们纳入了提供与我们研究目标相关的荟萃分析的系统评价。采用 AMSTAR 2 评估方法学质量,采用 GRADE 评估证据确定性。本综述已在 PROSPERO(CRD42021230784)注册。我们共确定了 30 篇文章,其中包括 45 个环境风险/保护因素(154594 例,730223 人)和 9 个生物标志物(2018 例,16757 人)。产前焦虑(OR 2.49,1.91-3.25)和心理暴力(OR 1.93,1.54-2.42)的证据可信度令人信服(I 级);亲密伴侣暴力经历(OR 2.86,2.12-3.87)、怀孕期间亲密伴侣暴力(RR 2.81,2.11-3.74)、怀孕期间吸烟(OR 2.39,1.78-3.2)、经前期综合征史(OR 2.2,1.81-2.68)、任何类型的暴力经历(OR 2.04,1.72-2.41)、初产妇与经产妇相比(RR 1.76,1.59-1.96)和意外怀孕(OR 1.53,1.35-1.75)的证据高度提示(II 级)。
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