Aziz Halimatusaadiyah Abdul, Yahya Huda Dianah Binte, Ang Wen Wei, Lau Ying
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
J Psychiatr Res. 2025 Jan;181:528-546. doi: 10.1016/j.jpsychires.2024.11.070. Epub 2024 Dec 5.
The global prevalence of psychological problems in different trimesters is unclear due to methodological constraints in previous reviews. A precise estimate would be a key first step in raising awareness and allocating resources. This review aims to (1) calculate the global prevalence of depression, anxiety, and stress symptoms during different trimesters and (2) determine the factors influencing their prevalence estimates. A comprehensive search across eight databases was conducted. The meta packages in R software were used to perform meta-analysis, subgroup analysis, and meta-regression analysis. The Newcastle Ottawa Scale was used to assess the study quality, while the Grading of Recommendations, Assessment, Development, and Evaluation method was utilized to assess the certainty of the evidence. A total of 88 studies with 61,719 participants across 48 countries were included. The prevalences of depression, anxiety, and stress symptoms during all trimesters were 27% (95% CI: 23-31), 37% (95% CI: 31-42), and 26% (95% CI: 9-49), respectively. The second trimester had the highest prevalence of depression (30%) and anxiety (28%) symptoms, whereas the third trimester had the highest prevalence of stress symptoms (52%). A series of subgroup and meta-regression analyses revealed that regions, economic levels of the country, setting, the COVID-19 pandemic, and quality of study were significant factors. Most studies were high quality, but the certainty of the evidence was very low. Findings can contribute as evidence to raising awareness about specific psychological problems during different trimesters. Implementing effective policies and launching targeted interventions can help minimize the prevalence.
由于既往综述存在方法学上的局限性，不同孕期心理问题的全球患病率尚不清楚。精确的估计将是提高认识和分配资源的关键第一步。本综述旨在：（1）计算不同孕期抑郁、焦虑和压力症状的全球患病率；（2）确定影响患病率估计的因素。对八个数据库进行了全面检索。使用R软件中的meta包进行荟萃分析、亚组分析和meta回归分析。采用纽卡斯尔渥太华量表评估研究质量，同时运用推荐意见分级、评估、制定与评价方法评估证据的确定性。共纳入来自48个国家的88项研究，涉及61719名参与者。所有孕期抑郁、焦虑和压力症状的患病率分别为27%（95%CI：23 - 31）、37%（95%CI：31 - 42）和26%（95%CI：9 - 49）。孕中期抑郁症状（30%）和焦虑症状（28%）的患病率最高，而孕晚期压力症状的患病率最高（52%）。一系列亚组分析和meta回归分析表明，地区、国家经济水平、研究环境、新冠疫情和研究质量是显著因素。大多数研究质量较高，但证据的确定性非常低。研究结果可为提高对不同孕期特定心理问题的认识提供证据。实施有效政策并开展针对性干预有助于降低患病率。
