Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK.
Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman.
Soc Psychiatry Psychiatr Epidemiol. 2023 Nov;58(11):1581-1590. doi: 10.1007/s00127-022-02386-9. Epub 2023 Jan 16.
This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the commonalities and discrepancies of the literature.
Seven databases were searched from inception until April 2022. Full-text screening and data extraction were performed independently by two researchers and the AMSTAR tool was used to assess the methodological quality.
128 systematic reviews were included in the analysis. Mean overall prevalence of perinatal depression, antenatal depression and postnatal depression was 26.3%, 28.5% and 27.6%, respectively. Mean prevalence was significantly higher (27.4%; SD = 12.6) in studies using self-reported measures compared with structured interviews (17.0%, SD = 4.5; d = 1.0) and among potentially vulnerable populations (32.5%; SD = 16.7, e.g. HIV-infected African women) compared to the general population (24.5%; SD = 8.1; d = 0.6). Personal history of mental illness, experiencing stressful life events, lack of social support, lifetime history of abuse, marital conflicts, maternity blues, child care stress, chronic physical health conditions, preeclampsia, gestational diabetes mellitus, being exposed to second-hand smoke and sleep disturbance were among the major correlates of perinatal depression.
Although the included systematic reviews were all of medium-high quality, improvements in the quality of primary research in this area should be encouraged. The standardisation of perinatal depression assessment, diagnosis and measurement, the implementation of longitudinal designs in studies, inclusions of samples that better represent the population and better control of potentially confounding variables are encouraged.
本系统综述旨在提供围产期抑郁症的流行率和相关因素的全球概况,并探讨文献中的共性和差异。
从创建到 2022 年 4 月,在七个数据库中进行了搜索。两名研究人员独立进行了全文筛选和数据提取,并使用 AMSTAR 工具评估了方法学质量。
共纳入了 128 篇系统综述进行分析。围产期抑郁症、产前抑郁症和产后抑郁症的总体平均患病率分别为 26.3%、28.5%和 27.6%。使用自我报告测量的研究的平均患病率明显较高(27.4%,SD=12.6),而使用结构化访谈的研究则较低(17.0%,SD=4.5;d=1.0);在潜在脆弱人群(例如感染艾滋病毒的非洲妇女)中的患病率也高于一般人群(32.5%,SD=16.7,e.g. HIV-infected African women)。个人精神病史、经历压力性生活事件、缺乏社会支持、终生虐待史、婚姻冲突、产后忧郁、育儿压力、慢性身体健康状况、先兆子痫、妊娠糖尿病、接触二手烟和睡眠障碍是围产期抑郁症的主要相关因素。
尽管纳入的系统综述均为中高质量,但应鼓励该领域的初级研究提高质量。鼓励围产期抑郁症评估、诊断和测量的标准化、研究中采用纵向设计、纳入更好代表人群的样本以及更好地控制潜在混杂变量。