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孕期基于正念的干预措施对产后心理健康的影响:一项荟萃分析。

The effect of mindfulness-based interventions during pregnancy on postpartum mental health: A meta-analysis.

作者信息

Min Wenjiao, Jiang Caixia, Li Zhengyu, Wang Zuxing

机构信息

Psychosomatic Department, Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China.

出版信息

J Affect Disord. 2023 Jun 15;331:452-460. doi: 10.1016/j.jad.2023.03.053. Epub 2023 Mar 23.

Abstract

BACKGROUND

Mindfulness helps reduce negative emotions, but its ability to prevent postpartum psychological problems remains unclear. This study aimed to assess the effects of mindfulness-based interventions (MBIs) during pregnancy on postpartum mental health, especially postpartum depression.

METHODS

Online databases regarding the effect of mindfulness on pregnancy were searched and a meta-analysis was conducted.

RESULTS

Eight randomized controlled trials (RCTs) and a self-controlled study were included. We found consistent results showing that MBIs significantly improve the depressive symptoms of all pregnant women in both the case-control (SMD = -0.90, 95 % CI (-2.71, -1.82), p = 0.01) and self-control (SMD = 1.24, 95 % CI (0.37, 2.11), p = 0.005) comparisons. However, MBIs were ineffective for high-risk pregnant women with severe depressive symptoms before delivery in both the case-control (SMD = -1.07, 95 % CI (-3.40, 1.25), p = 0.36) and self-control comparisons (SMD = 2.10, 95 % CI (-0.26, 4.47), p = 0.08). Furthermore, MBIs did not have significant advantages over other intervention methods (SMD = -0.45, 95 % CI (-1.17, 0.28), p = 0.23).

LIMITATIONS

There were few high-quality RCTs, and the sample size was small.

CONCLUSION

MBIs can relieve maternal depressive and anxiety symptoms, especially for the prevention of postpartum depression in healthy pregnant women. However, MBIs do not have significant advantages over other interventions and may not be useful for all pregnant women. These findings contribute to the optimization of perinatal mental health intervention programs and the improvement of pregnancy outcomes, playing an important guiding role in clinical decision-making.

摘要

背景

正念有助于减少负面情绪,但其预防产后心理问题的能力尚不清楚。本研究旨在评估孕期基于正念的干预措施(MBIs)对产后心理健康的影响,尤其是产后抑郁。

方法

检索关于正念对孕期影响的在线数据库并进行荟萃分析。

结果

纳入八项随机对照试验(RCT)和一项自身对照研究。我们发现一致的结果表明,在病例对照比较(标准化均数差[SMD]= -0.90,95%可信区间[-2.71,-1.82],p = 0.01)和自身对照比较(SMD = 1.24,95%可信区间[0.37,2.11],p = 0.005)中,MBIs均显著改善了所有孕妇的抑郁症状。然而,在病例对照比较(SMD = -1.07,95%可信区间[-3.40,1.25],p = 0.36)和自身对照比较(SMD = 2.10,95%可信区间[-0.26,4.47],p = 0.08)中,MBIs对分娩前有严重抑郁症状的高危孕妇无效。此外,MBIs与其他干预方法相比没有显著优势(SMD = -0.45,95%可信区间[-1.17,0.28],p = 0.23)。

局限性

高质量的RCT较少,样本量较小。

结论

MBIs可缓解产妇的抑郁和焦虑症状,尤其是对预防健康孕妇的产后抑郁。然而,MBIs与其他干预措施相比没有显著优势,可能并非对所有孕妇都有用。这些研究结果有助于优化围产期心理健康干预方案并改善妊娠结局,对临床决策具有重要指导作用。

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