Shahiri Sobhan, Mirzohreh Seyedeh-Tarlan, Azizi Hosein, Esmaeili Elham Davtalab, Pourmousavi Laleh, Hosseini Leila, Farzadi Laya
Women's Reproductive Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Psychiatry. 2025 Jul 30;25(1):742. doi: 10.1186/s12888-025-07210-7.
The prevalence of suicidal ideation (SI) among HIV-positive pregnant women is a complex issue influenced by multiple risk factors. By addressing these risk factors and focusing on vulnerable regions, healthcare providers and policymakers can strive to alleviate the burden of SI in this population. The objective of this systematic review, meta-analysis, and meta-regression was to estimate the prevalence and identify risk factors for SI among HIV-positive pregnant women.
The review systematically searched PubMed, Scopus and Web of Science to identify relevant studies published until December 2024. A meta-analysis was conducted to summarize the prevalence and risk factors for SI among pregnant women with HIV infection. Sensitivity and meta-regression analysis were performed to explore the potential sources of heterogeneity in the distribution and determinants of suicidal behaviors within this at-risk group.
The review identified 18 studies involving 5,242 participants. The overall prevalence of SI was 20.5%; 95% CI: 14.6 - 28.0% in pregnant women living with HIV, 19.8%; 95% CI: 12.6 - 29.6% in perinatal, and 14.9%; 95% CI: 7.8 - 26.5% in prenatal. The prevalence of SI was 17.1%, 20.3%, and 34.5% for the periods 2020-2024, 2015-2019, and 2000-2014, respectively. By gross domestic product (GDP), the prevalence was 16.9% in low, 23.0% in moderate, and 24.1% in high GDP countries, with the highest prevalence in the USA (24.2%). Among various risk factors, partner violence (OR = 1.44; 95% CI: 1.05-1.98), and higher education (OR = 0.80; 95% CI: 0.64-0.99) were identified as significant risk factors and protective factors, respectively. Meta-regression analysis indicated that GDP, partner violence, year, age, and depression were potential sources of heterogeneity, respectively.
The results indicated a high prevalence of SI among perinatal women living with HIV. The educational level, GDP, partner violence, and year were significant risk factors and potential sources of heterogeneity. It is crucial to incorporate specific questions about suicidal ideation into routine prenatal care for this population, even when depressive symptoms are not apparent. These findings underscore the need for a multifaceted approach to addressing suicidal ideation in HIV-positive prenatal women.
HIV 阳性孕妇中自杀意念（SI）的患病率是一个受多种风险因素影响的复杂问题。通过解决这些风险因素并关注脆弱地区，医疗保健提供者和政策制定者可以努力减轻该人群中 SI 的负担。本系统评价、荟萃分析和荟萃回归的目的是估计 HIV 阳性孕妇中 SI 的患病率并确定其风险因素。
该评价系统检索了 PubMed、Scopus 和 Web of Science，以识别截至 2024 年 12 月发表的相关研究。进行荟萃分析以总结 HIV 感染孕妇中 SI 的患病率和风险因素。进行敏感性和荟萃回归分析以探索该高危人群中自杀行为分布和决定因素异质性的潜在来源。
该评价纳入了 18 项研究，涉及 5242 名参与者。SI 的总体患病率为 20.5%；HIV 阳性孕妇中的患病率为 19.8%，95%CI：14.6 - 28.0%；围产期患病率为 19.8%，95%CI：12.6 - 29.6%；产前患病率为 14.9%，95%CI：7.8 - 26.5%。2020 - 2024 年、2015 - 2019 年和 2000 - 2014 年期间 SI 的患病率分别为 17.1%、20.3%和 34.5%。按国内生产总值（GDP）划分，低 GDP 国家的患病率为 16.9%，中等 GDP 国家为 23.0%，高 GDP 国家为 24.1%，美国患病率最高（24.2%）。在各种风险因素中，伴侣暴力（OR = 1.44；95%CI：1.05 - 1.98）和高等教育（OR = 0.80；95%CI：0.64 - 0.99）分别被确定为显著风险因素和保护因素。荟萃回归分析表明，GDP、伴侣暴力、年份、年龄和抑郁分别是异质性的潜在来源。
结果表明，HIV 感染的围产期妇女中 SI 的患病率很高。教育水平、GDP、伴侣暴力和年份是显著风险因素和潜在的异质性来源。即使抑郁症状不明显，将关于自杀意念的特定问题纳入该人群的常规产前护理中也至关重要。这些发现强调了采用多方面方法解决 HIV 阳性产前妇女自杀意念问题的必要性。
