MSc "Strategies of Developmental and Adolescent Health", School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece.
J Affect Disord. 2022 Dec 1;318:314-330. doi: 10.1016/j.jad.2022.08.055. Epub 2022 Sep 9.
Postpartum depression (PPD) is a disorder that has a severe impact on a woman's mental state and mood after birth. Research has shown that postnatal levels of family adversity and maternal psychopathology are associated with Attention Deficit Hyperactivity Disorder (ADHD). This paper is intended to examine the association among maternal PPD and the risk of ADHD in the offspring.
Keyword search was conducted for PsycINFO, PubMed, Google Scholar, and Embase up to Feb 28, 2021; studies in English were deemed eligible. Random-effects meta-analysis and meta-regression analysis took place. Subgroup analyses by study design, geographical region, level of adjustment and study setting were performed.
Nine cohort studies and two case-control studies published from 2003 to 2019 were included in the qualitative synthesis; among them, eight studies were synthesized in the meta-analysis. Overall, maternal PPD was associated with an increased risk of ADHD in the offspring (pooled relative risk, RR = 1.69, 95%CI: 1.27-2.26). Significant associations were noted in the subsets of cohort studies, studies implementing multivariate analyses and registry-based surveys.
Overall, a larger number of studies of the field are needed. Data collection relied on self-report and attrition bias limited the validity of eligible studies. Studies from developing countries were underrepresented. There was significant publication bias (p = 0.035, Egger's test).
The relationship between PPD and ADHD in children was found to be significant in this systematic review and meta-analysis and reveals the need for further investigation in various geographical regions.
产后抑郁症（PPD）是一种在女性产后对其精神状态和情绪产生严重影响的疾病。研究表明，产后家庭逆境和产妇精神病理学水平与注意力缺陷多动障碍（ADHD）有关。本文旨在研究母亲产后抑郁症与后代患 ADHD 的风险之间的关联。
截至 2021 年 2 月 28 日，对 PsycINFO、PubMed、Google Scholar 和 Embase 进行了关键词搜索；符合条件的研究为英文研究。进行了随机效应荟萃分析和荟萃回归分析。按研究设计、地理位置、调整水平和研究场所进行了亚组分析。
纳入了 2003 年至 2019 年发表的 9 项队列研究和 2 项病例对照研究，其中 8 项研究进行了荟萃分析。总体而言，母亲产后抑郁症与后代患 ADHD 的风险增加相关（合并相对风险，RR=1.69，95%CI：1.27-2.26）。在队列研究的亚组、实施多变量分析的研究和基于登记的调查中，均观察到了显著的相关性。
总体而言，该领域需要更多的研究。数据收集依赖于自我报告，并且存在失访偏倚，这限制了合格研究的有效性。来自发展中国家的研究代表性不足。存在显著的发表偏倚（p=0.035，Egger 检验）。
在本系统评价和荟萃分析中，发现产后抑郁症与儿童 ADHD 之间存在显著关联，这表明需要在各个地理区域进一步调查。
