Soehl John R, Anthony Kathryn, Lewkowitz Adam K, Fletcher Lauren, Ward L G, Miller Emily S
Warren Alpert School of Medicine at Brown University, Department of Maternal Fetal Medicine, Providence, RI (Soehl, Lewkowitz and Miller).
Warren Alpert School of Medicine at Brown University, Department of Obstetrics & Gynecology, Providence, RI (Anthony).
Am J Obstet Gynecol MFM. 2025 Mar;7(3):101613. doi: 10.1016/j.ajogmf.2025.101613. Epub 2025 Jan 23.
To systematically evaluate inpatient interventions to reduce symptoms of anxiety, depression, or stress in pregnant individuals during antepartum hospitalization.
Searches were conducted in Ovid MEDLINE, Embase, CINAHL Plus, Cochrane CENTRAL, and PsycINFO from database inception through April 2023.
Randomized controlled trials and cohort studies were eligible for inclusion if an intervention was compared to treatment as usual (TAU) to reduce symptoms of anxiety, depression, or stress among pregnant individuals admitted to a hospital's antepartum unit.
Two authors independently screened all abstracts for eligibility and reviewed all potentially eligible full-text articles for inclusion. The primary outcome was the score on the assessment for symptoms of anxiety, depression, or stress after the intervention. The Hedges method was used to detect standardized mean difference (SMD) in studies using different psychometric scales, and weighted mean differences (WMD) were used in studies using the same psychometric scales. Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions.
Of 1185 articles originally identified, 19 full-text manuscripts were reviewed, and 3 studies (all randomized controlled studies)-corresponding to 226 patients randomized to an intervention and 263 patients randomized to TAU-were included. Compared to TAU, interventions significantly reduced mean scores on validated scales assessing symptoms of anxiety (SMD -0.65 [95% Confidence Interval (CI) -0.83, -0.46]), depression (WMD -0.52 [95% CI -0.76, -0.28]), and stress (WMD -0.57 [95% CI -0.82, -0.31]).
Though data are limited, interventions given to birthing people who experience antepartum hospitalization modestly-but significantly-reduce symptoms of anxiety, depression, and stress. These data highlight a need for further high-quality trials to support the mental health needs of this high-risk population.
This project was supported by the Department of Maternal Fetal Medicine at the Alpert School of Medicine of Brown University. AKL was supported by NICHD (K23HD103961). ESM was supported by NICHD (R01HD105499) and NINR (R01NR021126-01). LGW was supported by K23HD107296-01A1 and P20GM139767.
PROSPERO, CRD42023444189 El resumen está disponible en Español al final del artículo.
系统评价住院干预措施，以减轻产前住院期间孕妇的焦虑、抑郁或压力症状。
从数据库建立至2023年4月，在Ovid MEDLINE、Embase、CINAHL Plus、Cochrane CENTRAL和PsycINFO中进行检索。
如果将一种干预措施与常规治疗（TAU）进行比较，以减轻入住医院产前病房的孕妇的焦虑、抑郁或压力症状，则随机对照试验和队列研究符合纳入条件。
两位作者独立筛选所有摘要以确定是否符合纳入标准，并审查所有可能符合条件的全文文章以确定是否纳入。主要结局是干预后焦虑、抑郁或压力症状评估的得分。在使用不同心理测量量表的研究中，使用Hedges方法检测标准化平均差（SMD），在使用相同心理测量量表的研究中，使用加权平均差（WMD）。使用Cochrane干预系统评价手册评估偏倚风险。
在最初识别的1185篇文章中，审查了19篇全文手稿，纳入了3项研究（均为随机对照研究），对应226例随机接受干预的患者和263例随机接受常规治疗的患者。与常规治疗相比，干预措施显著降低了评估焦虑症状（SMD -0.65 [95%置信区间（CI）-0.83，-0.46]）、抑郁症状（WMD -0.52 [95% CI -0.76，-0.28]）和压力症状（WMD -0.57 [95% CI -0.82，-0.31]）的有效量表上的平均得分。
尽管数据有限，但对经历产前住院的产妇进行的干预措施适度但显著地减轻了焦虑、抑郁和压力症状。这些数据凸显了需要进一步开展高质量试验，以支持这一高危人群的心理健康需求。
本项目由布朗大学阿尔珀特医学院母胎医学系资助。AKL由美国国立儿童健康与人类发展研究所（K23HD103961）资助。ESM由美国国立儿童健康与人类发展研究所（R01HD105499）和美国国立护理研究机构（R01NR021126-01）资助。LGW由K23HD107296-01A1和P20GM139767资助。
PROSPERO，CRD42023444189 摘要可在文章末尾查看西班牙语版本。
