Jones Katie, Folliard Kelda, Di Malta Gina, Oates John, Gilbert Leah, Harrison Virginia
School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK.
School of Health Sciences, University of East Anglia, UK.
J Affect Disord. 2025 Mar 15;373:478-494. doi: 10.1016/j.jad.2024.12.043. Epub 2025 Jan 6.
Reducing the prevalence and consequences of anxiety following childbirth (postpartum anxiety) is a strategic priority in the UK and many similar nations; a comprehensive review of risk factors can support the development of interventions and guide further research.
This registered systematic review was guided by 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and analysed using 'Synthesis Without Meta-analysis' (SWiM) to answer the question; 'What factors have been reported to increase the risk of maternal postpartum anxiety (PPA) in Australia, Europe, and North America?'. MEDLINE and PsycINFO were searched for relevant research from Australia, Europe, and North America, published up to July 2021.
Screening yielded 39 reports (total N = 40,238). Seven risk categories were identified (Psychopathology and personality, Social, Socio-demographic, Health, Cognitive, Pregnancy and birth, and Infant characteristics and postpartum experiences). Historic and concurrent depression, historic anxiety, and low social support were the most frequently evidenced risk factors.
The review was limited to three geographical regions with comparable health, political, and cultural contexts, and research pertaining only to special populations was excluded.
Findings synthesise new evidence of the risk factors associated with PPA, whilst the discussion highlights potentially modifiable factors as targets for intervention. Monitoring for risk factors during routine pregnancy and postpartum care would allow for additional surveillance and earlier intervention with those most at risk. Peer support should be offered to people with heightened vulnerability to PPA. Developing support strategies that address cognitive vulnerabilities (e.g., parenting-related confidence) could prove particularly beneficial.
降低产后焦虑的患病率及其影响是英国和许多类似国家的一项战略重点；对风险因素进行全面综述有助于制定干预措施并为进一步研究提供指导。
本注册系统综述以“系统评价与Meta分析的首选报告项目”（PRISMA）为指导，并使用“非Meta分析的综合分析”（SWiM）进行分析，以回答以下问题：“在澳大利亚、欧洲和北美，有哪些因素被报道会增加产妇产后焦虑（PPA）的风险？”。检索了MEDLINE和PsycINFO中截至2021年7月发表的来自澳大利亚、欧洲和北美的相关研究。
筛选出39篇报告（总样本量N = 40,238）。确定了七个风险类别（精神病理学与人格、社会、社会人口统计学、健康、认知、妊娠与分娩、婴儿特征与产后经历）。既往和同时存在的抑郁症、既往焦虑症和社会支持不足是最常被证实的风险因素。
本综述仅限于健康、政治和文化背景相似的三个地理区域，且仅涉及特殊人群的研究被排除在外。
研究结果综合了与PPA相关的风险因素的新证据，而讨论部分强调了潜在的可改变因素作为干预目标。在常规孕期和产后护理中监测风险因素将有助于进行额外监测，并对高危人群进行早期干预。应为PPA易感性较高的人群提供同伴支持。制定针对认知脆弱性（如育儿相关信心）的支持策略可能会特别有益。
