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人工流产与抑郁症之间的关联:一项系统评价与荟萃分析

[Association between induced abortion and depression: A systematic review and meta-analysis].

作者信息

Montoya-Gambini Nadia Jenniffer Stefany, Apaza-García Jessica Jennifer, Munares-García Oscar Fausto

机构信息

Universidad Científica del Sur, Facultad de Ciencias de la Salud "Fernando Cabieses Molina", Carrera de Medicina Humana. Lima, Perú.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Jan 8;62(1):1-9. doi: 10.5281/zenodo.10278156.

Abstract

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.

摘要

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。

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