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正念干预在孕期和对产后抑郁和产妇心理健康的长期影响:一项随机对照试验的系统评价和荟萃分析。

Mindfulness-Based Interventions During Pregnancy and Long-Term Effects on Postpartum Depression and Maternal Mental Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

机构信息

Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital and University, Milan, Italy.

Tor Vergata University, Rome, Italy.

出版信息

J Integr Complement Med. 2024 Feb;30(2):107-120. doi: 10.1089/jicm.2023.0114. Epub 2023 Aug 28.

Abstract

Preventing postpartum depression (PPD) is a public health goal. The scientific literature has demonstrated the short-term efficacy of Mindfulness-Based Interventions (MBIs) delivered during pregnancy on PPD. Nevertheless, the long-term outcomes of MBIs are still unclear. Systematic review and meta-analysis of randomized controlled trials (RCTs). Four databases were searched to identify RCTs focused on describing the efficacy of MBIs on PPD and published in English up to February 2022. The study was conducted globally. Pregnant women who received MBIs. MBIs were delivered during pregnancy in the included RCTs. Data collection and analysis effect size were combined using a random-effects model. The reporting in this study was consistent with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Six studies were included. The overall effect size significantly reduced PPD symptoms severity in the MBI group versus the control group in the first 3 months after childbirth (standardized mean difference = -0.26; 95% confidence interval = -0.51 to -0.01;  = 30.65%). The effects of MBIs were significant in women who started MBIs with a low risk of developing PPD. MBIs delivered during pregnancy have long-term benefits for PPD. Further studies focused on testing MBIs starting during pregnancy and lasting over the postpartum and modulating the intensity of delivering MBIs based on the risk for developing PPD are needed to inform the practice with solid evidence.

摘要

预防产后抑郁症 (PPD) 是一个公共卫生目标。科学文献已经证明了在怀孕期间进行的正念干预 (MBIs) 在预防 PPD 方面的短期疗效。然而,MBIs 的长期效果仍不清楚。

系统评价和随机对照试验 (RCT) 的荟萃分析。检索了四个数据库,以确定专注于描述正念干预对 PPD 疗效的 RCT,并于 2022 年 2 月之前以英文发表。研究在全球范围内进行。

接受正念干预的孕妇。

在纳入的 RCT 中,正念干预是在怀孕期间进行的。

使用随机效应模型合并数据收集和分析效应大小。本研究的报告符合系统评价和荟萃分析的首选报告项目 (PRISMA) 指南。

纳入了 6 项研究。总体效应大小表明,与对照组相比,MBI 组在产后 3 个月内 PPD 症状严重程度显著降低(标准化均数差 = -0.26;95%置信区间 = -0.51 至 -0.01; = 30.65%)。在开始 MBIs 时 PPD 发病风险较低的女性中,MBIs 的效果更为显著。

在怀孕期间进行的 MBIs 对 PPD 具有长期益处。

需要进一步研究,重点是测试从怀孕期间开始并持续到产后的 MBIs,并根据 PPD 的发病风险调整 MBIs 的强度,以便用确凿的证据为实践提供信息。

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