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乌干达 COVID-19 大流行前后女性产后抑郁症及其相关因素的系统评价和荟萃分析

Systematic review and meta-analysis of postpartum depression and its associated factors among women before and after the COVID-19 pandemic in Uganda.

作者信息

Kabunga Amir, Tumwesigye Raymond, Kigongo Eustes, Musinguzi Marvin, Acup Walter, Auma Anna Grace

机构信息

Department of Psychiatry, Lira University, Lira, Uganda

Lira University, Lira, Uganda.

出版信息

BMJ Open. 2024 Jul 31;14(7):e076847. doi: 10.1136/bmjopen-2023-076847.

Abstract

OBJECTIVE

This meta-analysis aimed to estimate the national prevalence of postpartum depression (PPD) in Uganda and identify predictors in both pre-COVID-19 and post-COVID-19 eras.

DESIGN

Used a systematic review and meta-analysis methodology.

DATA SOURCES

Reviewed papers were sourced from Medline/PubMed, PsycINFO, CINAHL/EBSCOhost, Google Scholar, ScienceDirect and African Journals Online.

ELIGIBILITY CRITERIA FOR SELECTED STUDIES

The review encompassed observational studies published on PPD in Uganda from 1 January 2000 to 30 November 2023.

RESULTS

11 studies (involving 7564 participants) published from 1 January 2000 to 30 November 2023 were reviewed. The pooled prevalence of PPD in Uganda was 29% (95% CI 21% to 37%, I=98.32%). Subgroup analysis indicated a similar prevalence before (29%, 95% CI 20% to 39%) and during (28%, 95% CI 22% to 32%) the COVID-19 period. Special groups exhibited a higher prevalence (32%, 95% CI 16% to 47%) than general postpartum women (28%, 95% CI 19% to 37%). Factors associated with PPD included poor social support (OR 1.19, 95% CI 1.17 to 1.22, I=96.8%), maternal illness (OR 1.22, 95% CI 1.19 to 1.26, I=96.9%), poor socioeconomic status (OR 1.43, 95% CI 1.40 to 1.46, I=99.5%) and undergoing caesarean section (OR 1.15, 95% CI 1.12 to 1.17, I=80.6%). Surprisingly, there was a marginal decrease in PPD during the COVID-19 period. Subgroup analysis highlighted a higher prevalence among mothers with HIV.

CONCLUSION

This study underscores the significant prevalence of PPD in Uganda, with sociodemographic factors increasing risk. Despite a slight decrease during the COVID-19 period, the importance of prioritising maternal mental health is emphasised, considering sociodemographic factors and pandemic challenges, to improve maternal and child health outcomes and overall well-being.

摘要

目的

本荟萃分析旨在评估乌干达产后抑郁症(PPD)的全国患病率,并确定新冠疫情前和疫情后时期的预测因素。

设计

采用系统评价和荟萃分析方法。

数据来源

纳入综述的论文来自Medline/PubMed、PsycINFO、CINAHL/EBSCOhost、谷歌学术、ScienceDirect和非洲期刊在线数据库。

入选研究的纳入标准

该综述涵盖了2000年1月1日至2023年11月30日期间在乌干达发表的关于产后抑郁症的观察性研究。

结果

对2000年1月1日至2023年11月30日期间发表的11项研究(涉及7564名参与者)进行了综述。乌干达产后抑郁症的合并患病率为29%(95%置信区间21%至37%,I=98.32%)。亚组分析表明,在新冠疫情期间之前(29%,95%置信区间20%至39%)和期间(28%,95%置信区间22%至32%)患病率相似。特殊群体的患病率(32%,95%置信区间16%至47%)高于一般产后妇女(28%,95%置信区间19%至37%)。与产后抑郁症相关的因素包括社会支持不足(比值比1.19,95%置信区间1.17至1.22,I=96.8%)、产妇疾病(比值比1.22,95%置信区间1.19至1.26,I=96.9%)、社会经济地位低下(比值比1.43,95%置信区间1.40至1.46,I=99.5%)以及剖宫产(比值比1.15,95%置信区间1.12至1.17,I=80.6%)。令人惊讶的是,在新冠疫情期间产后抑郁症患病率略有下降。亚组分析突出了感染艾滋病毒的母亲中患病率较高。

结论

本研究强调了乌干达产后抑郁症的高患病率,社会人口学因素会增加患病风险。尽管在新冠疫情期间患病率略有下降,但考虑到社会人口学因素和疫情挑战,强调了优先关注孕产妇心理健康对于改善母婴健康结局和整体福祉的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8124/11293379/dbf5f60e8967/bmjopen-14-7-g001.jpg

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