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中国大陆地区产后创伤后应激障碍的流行情况及其决定因素:系统评价和荟萃分析。

Prevalence of postpartum post-traumatic stress disorder and its determinants in Mainland China: A systematic review and meta-analysis.

机构信息

Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Xiang Ya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China.

Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Department of Pediatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Proviince, 410013, China.

出版信息

Arch Psychiatr Nurs. 2023 Jun;44:76-85. doi: 10.1016/j.apnu.2023.04.007. Epub 2023 Apr 23.

Abstract

BACKGROUND

The prevalence and risk factors of postpartum posttraumatic stress disorder reported by population-based studies have significantly varied and the data are all collected from regional populations in Mainland China.

AIMS

To utilize published data to estimate the overall prevalence of postpartum posttraumatic stress disorder and its determinants in Mainland China.

METHODS

Comprehensively electronic searches were performed across six English databases and three Chinese databases. Random effects of the meta-analysis were performed to evaluate the pooled prevalence of postpartum posttraumatic stress disorder. Meta-regression was performed with the variable of study design, sample size, setting, measures, region, time points, and publication year.

RESULTS

Totaling of nineteen studies was included, with a sample size of 13,231 postpartum women. The pooled prevalence of postpartum posttraumatic stress disorder was 11.2 % in Mainland China, with a higher prevalence at the timepoint within 1 month postpartum (18.1 %). Significant publication bias and heterogeneity were found (I = 97.1 %). Sample size and measurements were conditional on the prevalence of postpartum posttraumatic stress disorder. Postpartum depressive symptoms, sleep problems, cesarean section, and low levels of social support were the major risk factors for postpartum posttraumatic stress disorder. While being the one child in the family was the protective factor.

CONCLUSION

An increasing prevalence of posttraumatic stress disorder within one month postpartum significantly arises awareness to provide screening and more mental health services during this period. Screening programs for postpartum posttraumatic stress disorder are still needed in Mainland China.

摘要

背景

基于人群的研究报告的产后创伤后应激障碍的患病率和危险因素差异很大,且所有数据均来自中国大陆的区域性人群。

目的

利用已发表的数据来估计中国大陆产后创伤后应激障碍的总体患病率及其决定因素。

方法

全面检索了六个英文数据库和三个中文数据库。采用荟萃分析的随机效应来评估产后创伤后应激障碍的总患病率。采用元回归分析研究设计、样本量、设置、测量、地区、时间点和出版年份等变量。

结果

共纳入了 19 项研究,样本量为 13231 名产后妇女。中国大陆产后创伤后应激障碍的总患病率为 11.2%,产后 1 个月内患病率较高(18.1%)。存在显著的发表偏倚和异质性(I=97.1%)。样本量和测量取决于产后创伤后应激障碍的患病率。产后抑郁症状、睡眠问题、剖宫产和社会支持水平低是产后创伤后应激障碍的主要危险因素。而作为家中的独生子是保护因素。

结论

产后 1 个月内创伤后应激障碍的患病率呈上升趋势,这显著提高了在此期间进行筛查和提供更多心理健康服务的意识。中国大陆仍需要开展产后创伤后应激障碍的筛查项目。

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