Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium.
Department of Family Medicine, Qingdao United Family Hospital, Qingdao, China.
Front Public Health. 2023 Feb 15;11:1102618. doi: 10.3389/fpubh.2023.1102618. eCollection 2023.
While the public is under serious pressure from the coronavirus disease 2019 (COVID-19), the final impact and possible contributing factors to postpartum depression symptoms (PPDS) remain unknown. Therefore, a meta-analysis to investigate the association between PPDS and the COVID-19 pandemic was carried out by comparing the data between pre-pandemic and post-pandemic timeframes and exploring the influencing factors.
This systematic review was prospectively registered and recorded in a study protocol (Prospero CRD42022336820, http://www.crd.york.ac.uk/PROSPERO). A comprehensive search of PubMed, Embase, Web of Science, CINALH, Cochrane and Scopus was cmpleted on June 6, 2022. Studies that compared the prevalence of PPD before and during the COVID-19 pandemic period were included.
Of 1766 citations identified, 22 studies were included with 15,098 participates before the COVID-19 pandemic and 11,836 participants during the COVID-19 pandemic. Overall, the analysis showed that the epidemic crisis was associated with an increased prevalence of PPDS (OR: 0.81 [0.68, 0.95], = 0.009, = 59%). Subgroup analysis was conducted according to the study characteristics and regions. Within the study characteristics classification, results showed an obvious increase in the prevalence of PPDS during the COVID-19 pandemic if PPDS cutoff was defined as Edinburgh postpartum depression score (EPDS) ≥13 points (OR: 0.72 [0.52, 0.98], = 0.03, = 67%) and an increased prevalence in follow-ups that happened after 2 weeks (≥ 2 weeks postpartum) (OR: 0.81 [0.68, 0.97], = 0.02, = 43%). Selected studies that were high-quality (OR: 0.79 [0.64, 0.97], = 0.02, = 56%) demonstrated an increased prevalence of PPDS during the COVID-19 pandemic period. Sorting by regional factors, studies conducted in Asia (OR: 0.81 [0.70, 0.93], = 0.003, = 0%) showed an increase of PPDS prevalence rates during the COVID-19 period, while studies conducted in Europe (OR: 0.82 [0.59, 1.13], = 0.23, = 71%) and North America (OR: 0.66 [0.42, 1.02], = 0.06, = 65%) showed no significant difference. All studies conducted in the developed (OR: 0.79 [0.64, 0.98], = 0.03, = 65%) and developing countries (OR: 0.81 [0.69, 0.94], = 0.007, = 0%) showed an increase of PPDS during the COVID-19 period.
The COVID-19 pandemic is associated with an increased prevalence of PPDS, especially after long-term follow-up and among the group with a high possibility of depression. The negative influence from the pandemic, causing more PPDS was significant in studies from Asia.
在公众深受 2019 年冠状病毒病（COVID-19）影响之际，产后抑郁症（PPDS）的最终影响和可能的促成因素仍不清楚。因此，通过比较大流行前后时间段的数据，开展了一项荟萃分析，以调查 PPDS 与 COVID-19 大流行之间的关联，并探讨了影响因素。
本系统评价前瞻性注册并记录在研究方案（PROSPERO CRD42022336820，http://www.crd.york.ac.uk/PROSPERO）中。于 2022 年 6 月 6 日全面检索了 PubMed、Embase、Web of Science、CINALH、Cochrane 和 Scopus 数据库。纳入比较 COVID-19 大流行前后时期 PPD 患病率的研究。
从 1766 条引文中共纳入 22 项研究，其中大流行前有 15098 名参与者，大流行期间有 11836 名参与者。总体而言，分析结果表明，疫情危机与 PPDS 患病率增加相关（OR：0.81 [0.68, 0.95]， = 0.009， = 59%）。根据研究特征和地区进行了亚组分析。在研究特征分类中，如果 PPDS 截断值定义为爱丁堡产后抑郁量表（EPDS）≥13 分（OR：0.72 [0.52, 0.98]， = 0.03， = 67%），并且在≥2 周（产后≥2 周）的随访中患病率增加（OR：0.81 [0.68, 0.97]， = 0.02， = 43%），则 COVID-19 大流行期间 PPDS 的患病率明显增加。选择高质量的研究（OR：0.79 [0.64, 0.97]， = 0.02， = 56%）表明 COVID-19 大流行期间 PPDS 的患病率增加。按区域因素分类，在亚洲进行的研究（OR：0.81 [0.70, 0.93]， = 0.003， = 0%）显示 COVID-19 期间 PPDS 患病率增加，而在欧洲（OR：0.82 [0.59, 1.13]， = 0.23， = 71%）和北美（OR：0.66 [0.42, 1.02]， = 0.06， = 65%）进行的研究则无显著差异。所有在发达国家（OR：0.79 [0.64, 0.98]， = 0.03， = 65%）和发展中国家（OR：0.81 [0.69, 0.94]， = 0.007， = 0%）进行的研究都显示 COVID-19 期间 PPDS 有所增加。
COVID-19 大流行与 PPDS 患病率增加有关，尤其是在长期随访后，以及在有更高抑郁可能性的人群中。大流行带来的负面影响，使亚洲地区的 PPDS 显著增加。
