Zou Linli, Wang Shu, Chen Jingfen, Krewski Daniel, Wen Shi Wu, Lai Xiaolu, Xie Ri-Hua
School of Nursing, Southern Medical University, Guangzhou, China.
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Birth. 2025 Mar;52(1):16-24. doi: 10.1111/birt.12871. Epub 2024 Nov 4.
Adverse childhood experiences (ACEs) are known contributors to lifelong mental health challenges. Despite studies linking ACEs to increased risk of adverse postpartum mental health outcomes, a systematic review on the occurrence of postpartum post-traumatic stress disorder (PTSD) in women with ACEs is lacking.
A systematic search was conducted in seven databases to retrieve studies from inception to January 31, 2024. A random-effects model was used to quantify weighted estimates of postpartum PTSD incidence. Statistical analysis was conducted using R software.
Seven studies were included in the system review. One study was identified as an outlier and excluded from the meta-analysis. Among the six remaining studies, 1186 women exposed to ACEs were identified, with 249 of them experiencing postpartum PTSD. The estimated incidence of postpartum PTSD among women exposed to ACEs was 22.6% (95% confidence interval [CI] 16.1%-29.8%). Subgroup analysis revealed significant variations in incidence depending on study settings (p < 0.01) and PTSD assessment methods (p < 0.01). Due to multicollinearity among the primary variables, a meta-regression to identify factors influencing study heterogeneity was not conducted.
The incidence of postpartum PTSD was 22.6% in women with ACEs, higher than that observed in the general obstetric population. This finding suggests the need to provide comprehensive postpartum care for these women.
童年不良经历（ACEs）是导致终身心理健康挑战的已知因素。尽管有研究将ACEs与产后不良心理健康结果风险增加联系起来，但缺乏关于有ACEs的女性产后创伤后应激障碍（PTSD）发生率的系统评价。
在七个数据库中进行系统检索，以检索从开始到2024年1月31日的研究。采用随机效应模型对产后PTSD发病率的加权估计进行量化。使用R软件进行统计分析。
系统评价纳入了七项研究。一项研究被确定为异常值并被排除在荟萃分析之外。在其余六项研究中，识别出1186名暴露于ACEs的女性，其中249人经历了产后PTSD。暴露于ACEs的女性产后PTSD的估计发病率为22.6%（95%置信区间[CI]16.1%-29.8%）。亚组分析显示，发病率因研究环境（p<0.01）和PTSD评估方法（p<0.01）而有显著差异。由于主要变量之间存在多重共线性，未进行识别影响研究异质性因素的元回归分析。
有ACEs的女性产后PTSD发病率为22.6%，高于普通产科人群。这一发现表明需要为这些女性提供全面的产后护理。
