Silverwood Victoria, Bullock Laurna, Jordan Joanne, Turner Katrina, Chew-Graham Carolyn A, Kingstone Tom, Dawson Shoba
School of Medicine, Keele University, Keele, UK
School of Medicine, Keele University, Keele, UK.
BJGP Open. 2023 Sep 19;7(3). doi: 10.3399/BJGPO.2023.0022. Print 2023 Sep.
Perinatal anxiety (PNA), anxiety that occurs during pregnancy and/or up to 12 months postpartum, is estimated to affect up to 21% of women, and may impact negatively on mothers, children, and their families. The National Institute for Health and Care Excellence (NICE) has called for further research around non-pharmacological interventions in primary care for PNA.
To summarise the available international evidence on non-pharmacological interventions for women with PNA in a primary care population.
DESIGN & SETTING: A meta-review of systematic reviews (SRs) with narrative synthesis was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance.
Systematic literature searches were conducted in 11 health-related databases up to June 2022. Titles, abstracts, and full-text articles were dual-screened against pre-defined eligibility criteria. A variety of study designs were included. Data were extracted about study participants, intervention design, and context. Quality appraisal was performed using the AMSTAR 2 tool (A MeaSurement Tool to Assess systematic Reviews). A patient and public involvement group informed and contributed towards this meta-review.
Twenty-four SRs were included in the meta-review. Interventions were grouped into the following six categories for analysis purposes: psychological therapies; mind-body activities; emotional support from healthcare professionals (HCPs); peer support; educational activities; and alternative or complementary therapies.
In addition to pharmacological and psychological therapies, this meta-review has demonstrated that there are many more options available for women to choose from that might be effective to manage their PNA. Evidence gaps are present in several intervention categories. Primary care clinicians and commissioners should endeavour to provide patients with a choice of these management options, promoting individual choice and patient-centred care.
围产期焦虑（PNA）是指在孕期和/或产后12个月内出现的焦虑，估计影响高达21%的女性，可能对母亲、儿童及其家庭产生负面影响。英国国家卫生与临床优化研究所（NICE）呼吁围绕初级保健中针对PNA的非药物干预措施开展进一步研究。
总结关于初级保健人群中患有PNA的女性的非药物干预措施的现有国际证据。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，对系统评价（SRs）进行了Meta综述，并进行叙述性综合分析。
截至2022年6月，在11个与健康相关的数据库中进行了系统的文献检索。根据预先定义的纳入标准对标题、摘要和全文文章进行双人筛选。纳入了多种研究设计。提取了有关研究参与者、干预设计和背景的数据。使用AMSTAR 2工具（一种评估系统评价的测量工具）进行质量评估。一个患者和公众参与小组为该Meta综述提供了信息并做出了贡献。
Meta综述纳入了24项SRs。为了分析目的，将干预措施分为以下六类：心理治疗；身心活动；医疗保健专业人员（HCPs）的情感支持；同伴支持；教育活动；以及替代或补充疗法。
除了药物和心理治疗外，该Meta综述表明，还有更多可供女性选择的选项，可能对管理她们的PNA有效。几个干预类别中存在证据空白。初级保健临床医生和专员应努力为患者提供这些管理选项的选择，促进个人选择和以患者为中心的护理。
