Deierlein Andrea Lauren, Park Curie, Patel Nishtha, Gagnier Robin, Thorpe Michele
School of Global Public Health, New York University, New York, NY, USA.
Rory Meyers College of Nursing, New York University, New York, NY, USA.
Arch Womens Ment Health. 2024 Sep 2. doi: 10.1007/s00737-024-01506-5.
This systematic review examined literature on mental health outcomes among women with disabilities living in high-income countries within the context of reproductive health, spanning menstruation through menopause.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, CINAHL, and PsycINFO databases for studies published through June 2023. Eligible studies were observational, quantitative, and included a comparison group without disabilities.
A total of 2,520 studies were evaluated and 27 studies met inclusion criteria. These studies assessed mental health during prepregnancy, pregnancy, postpartum, and parenting among women with and without disabilities. None of the studies examined reproductive health time periods related to menstruation, fertility, or menopause. Women of reproductive age with disabilities were more likely to have poor mental health outcomes compared to women without disabilities. During pregnancy and the postpartum, women with disabilities were at greater risk of diagnosed perinatal mental disorders and psychiatric-related healthcare visits. Findings also suggested mental distress and inadequate emotional and social support related to parenting among women with disabilities. The greatest risks of poor mental health outcomes were often observed among women with intellectual and developmental disabilities and among women with multiple types of disabilities, compared to women without disabilities.
Routine reproductive healthcare visits provide significant prevention and treatment opportunities for poor mental health among women with disabilities. Further research examining mental health outcomes within the context of reproductive health, especially understudied areas of menstruation, fertility, parenting, and menopause, among women with disabilities is needed.
本系统评价在生殖健康背景下，对高收入国家残疾女性的心理健康结果相关文献进行了研究，涵盖从月经到更年期的整个阶段。
按照系统评价和Meta分析的首选报告项目指南，我们在MEDLINE、CINAHL和PsycINFO数据库中检索了截至2023年6月发表的研究。符合条件的研究为观察性、定量研究，并包括一个无残疾的对照组。
共评估了2520项研究，27项研究符合纳入标准。这些研究评估了残疾和非残疾女性在孕前、孕期、产后及育儿期间的心理健康状况。没有一项研究考察与月经、生育或更年期相关的生殖健康时间段。与非残疾女性相比，育龄残疾女性更有可能出现不良心理健康结果。在孕期和产后，残疾女性被诊断为围产期精神障碍及与精神疾病相关的医疗就诊风险更高。研究结果还表明，残疾女性在育儿方面存在精神困扰以及情感和社会支持不足的问题。与非残疾女性相比，智力和发育障碍女性以及患有多种残疾的女性往往出现不良心理健康结果的风险最高。
常规生殖健康检查为残疾女性心理健康不佳提供了重要的预防和治疗机会。需要进一步研究残疾女性在生殖健康背景下的心理健康结果，特别是月经、生育、育儿和更年期等研究较少的领域。
