Li Hongyan, Li Hongying, Zhong Jianjiong, Wu Qingfeng, Shen Lili, Tao Zhen, Zhang Huijia, Song Shengjun
Department of General Psychiatry, Kangci Hospital, Jiaxing, No. 3118 Huancheng North Road, Tongxiang City, Zhejiang Province, China.
Department of Neurology, Tongxiang First People's Hospital, Tongxiang City, Zhejiang Province, China.
Arch Womens Ment Health. 2023 Apr;26(2):259-267. doi: 10.1007/s00737-023-01295-3. Epub 2023 Feb 4.
Sleep disorders are common among pregnant females. However, its association with postpartum depression (PPD) is unknown. We aimed to assess if sleep disorders during pregnancy increase the risk of PPD by a systematic review. The databases of PubMed, CENTRAL, ScienceDirect, Embase, and Google Scholar were searched for studies reporting the association between any type of sleep disorder during pregnancy and the risk of PPD. Effect sizes were pooled in a random-effects model. Sixteen studies with data of 12,614 women were included. Meta-analysis indicated that sleep disorders during pregnancy resulted in a statistically significant increased risk of PPD (OR: 2.36 95% CI: 1.72, 2.32). The overall result had high heterogeneity (I = 84%). Sub-group analysis based on study location (Asian vs Western), sample size (> 500 vs < 500), depression scale, and PPD assessment time did not change the results. However, we found that only poor sleep quality but not insomnia was associated with PPD. The risk was also increased only with sleep disorders measured in the 3rd trimester but not for the 1st and 2nd trimesters. Evidence suggests that sleep disorders during pregnancy may increase risk of PPD. The risk is high for sleep disorders occurring in the 3rd trimester. Based on these findings, there is a need for thorough screening and subsequent corrective measures to ensure adequate and quality sleep among pregnant females.
睡眠障碍在怀孕女性中很常见。然而，其与产后抑郁症（PPD）之间的关联尚不清楚。我们旨在通过系统评价来评估孕期睡眠障碍是否会增加患产后抑郁症的风险。我们在PubMed、CENTRAL、ScienceDirect、Embase和谷歌学术数据库中搜索了报告孕期任何类型睡眠障碍与产后抑郁症风险之间关联的研究。效应量采用随机效应模型进行汇总。纳入了16项研究，涉及12,614名女性的数据。荟萃分析表明，孕期睡眠障碍导致产后抑郁症的风险在统计学上显著增加（比值比：2.36，95%置信区间：1.72，2.32）。总体结果具有高度异质性（I² = 84%）。基于研究地点（亚洲与西方）、样本量（> 500与< 500）、抑郁量表和产后抑郁症评估时间的亚组分析并未改变结果。然而，我们发现只有睡眠质量差而非失眠与产后抑郁症有关。风险也仅在孕晚期测量的睡眠障碍中增加，而在孕早期和孕中期则没有。有证据表明，孕期睡眠障碍可能会增加患产后抑郁症的风险。孕晚期出现的睡眠障碍风险很高。基于这些发现，有必要进行全面筛查并采取后续纠正措施，以确保怀孕女性获得充足且高质量的睡眠。
