Montoya-Gambini Nadia Jenniffer Stefany, Apaza-García Jessica Jennifer, Munares-García Oscar Fausto
Universidad Científica del Sur, Facultad de Ciencias de la Salud "Fernando Cabieses Molina", Carrera de Medicina Humana. Lima, Perú.
Rev Med Inst Mex Seguro Soc. 2024 Jan 8;62(1):1-9. doi: 10.5281/zenodo.10278156.
This article is a systematic review (SR) and meta-analysis (MA) whose objective was to identify the association between induced abortion and the development of depression, based on the Cochrane guidelines for SRs. A systematic search was carried out in the WoS, PubMed and Scopus databases. Retrospective and prospective cohort studies, carried out until November 2020, that evaluated a population of women in childbearing age (12 to 46 years) with at least 1 induced and/or provoked abortion, including pharma-cological and surgical abortion. Only studies with healthy women at the beginning of the research were included, i.e., with absence of psychiatric pathology prior to induced abor-tion. The quality of the included studies was measured with the Newcastle-Ottawa Scale (NOS), and for the MA random-effects models were specified using the DerSimonian & Laird method, grouping them into follow-up after abortion before and after one year. The results of the SR were measured with relative risk (RR), hazard ratio (HR), odds ratio (OR), and the chi-square test, which assessed the intensity of the statistical relationship between population and exposure. Systematic review demonstrated an OR of 1.38 (95% CI 1.14-1.68) of depression after induced abortion. Meta-analysis demonstrated a statis-tically significant association between depression and induced abortion when the as-sessment after one year was performed OR: 1.37 (95% CI 1.09-1.71). The risks, harms and mental health consequences of induced abortion, such as depression, should be in-vestigated and warned.
本文是一项系统评价（SR）和荟萃分析（MA），其目的是根据Cochrane系统评价指南，确定人工流产与抑郁症发生之间的关联。我们在Web of Science、PubMed和Scopus数据库中进行了系统检索。纳入了截至2020年11月开展的回顾性和前瞻性队列研究，这些研究评估了年龄在12至46岁之间、至少有1次人工流产和/或药物流产经历的育龄女性群体，包括药物流产和手术流产。仅纳入研究开始时为健康女性的研究，即人工流产前无精神疾病史的研究。采用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量，对于荟萃分析，使用DerSimonian & Laird方法指定随机效应模型，将其分为流产后1年前后的随访组。系统评价的结果采用相对危险度（RR）、风险比（HR）、比值比（OR）和卡方检验进行衡量，这些指标评估了人群与暴露之间统计关系的强度。系统评价显示人工流产后发生抑郁症的OR为1.38（95%CI 1.14 - 1.68）。荟萃分析表明，在进行1年评估时，抑郁症与人工流产之间存在统计学上的显著关联，OR为1.37（95%CI 1.09 - 1.71）。人工流产的风险、危害及心理健康后果，如抑郁症，应进行调查并予以警示。
