Department of History and Philosophy of Science, University of Cambridge, Cambridge, UK (Wetzler); Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY (Wetzler).
Department of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (Wishlade, Aiken).
Am J Obstet Gynecol MFM. 2024 Nov;6(11):101494. doi: 10.1016/j.ajogmf.2024.101494. Epub 2024 Sep 17.
Hypertensive disorders are major causes of maternal and neonatal morbidity and mortality, affecting ∼10% pregnancies worldwide.
Understanding the lived experience of women with hypertensive disorders during pregnancy is important to inform best practice and provide holistic care.
This is a systematic review and meta-synthesis of studies containing qualitative components relating to direct lived experience of hypertensive disorders of pregnancy. Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsycINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via ProQuest were searched between database inception and June 2024. Quality assessment was performed using the Critical Appraisal Skills Programme checklist for qualitative research. Themes were labeled and organized into a framework using NVivo software.
Eighteen studies were included in the meta-synthesis. Anxiety, stress, fear and panic emerged as the most common emotional experiences during hypertensive disorders of pregnancy. Loss of control was also mentioned frequently and consistently across studies (frequency effect size 38.9% and intensity effect size 15.3%). Emotional responses to physical symptoms or lack thereof, and feelings about the impact of the complicated pregnancy on family and community also emerged as central themes associated with hypertensive disorders of pregnancy.
A range of emotional experiences was captured across the studies included in our meta-synthesis, some of which were observed across global settings whereas others were context-dependent. Interventions and care pathways for pregnancies affected by hypertensive disorders should aim to support women through complex emotional experiences as well as reducing morbidity and mortality.
高血压疾病是导致产妇和新生儿发病率和死亡率的主要原因，影响着全球约 10%的妊娠。
了解妊娠高血压疾病女性的真实体验对于提供最佳实践和全面护理非常重要。
这是一项对包含与妊娠高血压疾病直接生活体验相关的定性内容的研究进行的系统回顾和元综合。通过 Ovid 中的 Medline、Ebsco 中的 Embase、Ebsco 中的 CINAHL、PsycINFO 中的 Ebsco、Scopus、Web of Science Core Collection 和 ProQuest 中的 ASSIA，在数据库建立到 2024 年 6 月之间进行了检索。使用批判性评估技能计划定性研究检查表对质量进行评估。使用 NVivo 软件对主题进行标记和组织成框架。
纳入的元综合包括 18 项研究。焦虑、压力、恐惧和恐慌是妊娠高血压疾病中最常见的情绪体验。在研究中也频繁且一致地提到失去控制（频率效应量 38.9%，强度效应量 15.3%）。对身体症状或缺乏身体症状的情绪反应，以及对复杂妊娠对家庭和社区的影响的感受，也成为与妊娠高血压疾病相关的核心主题。
我们的元综合中纳入的研究捕捉到了一系列的情绪体验，其中一些在全球范围内观察到，而另一些则取决于具体情况。受高血压疾病影响的妊娠的干预和护理途径应旨在支持女性应对复杂的情绪体验，同时降低发病率和死亡率。
