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不良儿童经历与产后抑郁症的关系:系统评价和荟萃分析。

The Relationship Between Adverse Childhood Experiences and Postpartum Depression: A Systematic Review and Meta-Analysis.

机构信息

Hebei Medical University, Shijiazhuang, China.

Clinical College of Hebei Medical University, Shijiazhuang, China.

出版信息

Trauma Violence Abuse. 2024 Oct;25(4):3066-3081. doi: 10.1177/15248380241235639. Epub 2024 Mar 22.

Abstract

Although numerous factors have been found to influence postpartum depression (PPD), no previous meta-analysis have systematically explored whether it is affected by adverse childhood experiences (ACEs). This study aimed to explore the influence of ACEs and their subtypes on PPD. A systematic literature search was conducted using Web of Science, PubMed, Embase, Wan Fang, China Science and Technology Journal Database, Chinese Biomedical Database, and China National Knowledge Infrastructure, and literature was screened according to inclusion and exclusion criteria. Methodological quality assessment and data extraction were performed on the included studies. A random-effects model was used to pool the effects. In total, 24 studies were included, and 73 independent effects were extracted from them. The meta-analysis revealed that ACE was a risk factor for PPD (odds ratio [OR] = 2.31, 95% confidence interval [CI] [2.04, 2.63]). The subgroup analysis results showed that emotional abuse was the ACE subtype most strongly related to the occurrence of PPD (OR = 2.95, 95% CI [2.08, 4.20]), followed by emotional neglect (OR = 2.87, 95% CI [1.89, 4.36]) and sexual abuse (OR = 2.81, 95% CI [1.93, 4.09]). In addition, family member incarceration (OR = 2.62, 95% CI [1.51, 4.54]), physical abuse (OR = 2.31, 95% CI [1.67, 3.19]), and physical neglect (OR = 2.15, 95% CI [1.36, 3.39]) also have strong effects on PPD. ACE is a risk factor for PPD. Early screening of ACE plays an important role in the prevention and intervention of PPD.

摘要

尽管有许多因素被发现会影响产后抑郁症(PPD),但以前的荟萃分析并没有系统地探讨过它是否受到不良儿童经历(ACEs)的影响。本研究旨在探讨 ACE 及其亚型对 PPD 的影响。使用 Web of Science、PubMed、Embase、万方、中国科技期刊数据库、中国生物医学文献数据库和中国国家知识基础设施对文献进行了系统检索,并根据纳入和排除标准对文献进行了筛选。对纳入的研究进行了方法学质量评估和数据提取。使用随机效应模型汇总效应。共纳入 24 项研究,从中提取了 73 个独立效应。荟萃分析显示,ACE 是 PPD 的危险因素(优势比 [OR] = 2.31,95%置信区间 [CI] [2.04, 2.63])。亚组分析结果表明,情感虐待是与 PPD 发生最密切相关的 ACE 亚型(OR = 2.95,95% CI [2.08, 4.20]),其次是情感忽视(OR = 2.87,95% CI [1.89, 4.36])和性虐待(OR = 2.81,95% CI [1.93, 4.09])。此外,家庭成员监禁(OR = 2.62,95% CI [1.51, 4.54])、身体虐待(OR = 2.31,95% CI [1.67, 3.19])和身体忽视(OR = 2.15,95% CI [1.36, 3.39])也对 PPD 有很强的影响。ACE 是 PPD 的危险因素。早期筛查 ACE 对 PPD 的预防和干预具有重要作用。

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