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Nursing Science 2024
孕期抑郁危险因素的Meta分析
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Abstract:
目的：探讨孕期抑郁发生的危险因素，为了解并预防孕期抑郁症的发生提供科学依据。方法：检索中国知网(CNKI)、万方数据库、维普网、PubMed、EMBASE、Web of Science等数据库，检索发表时间为从建库至2023年5月31日的有关孕期抑郁症发病的影响因素的研究文献，检索词包括“孕期”、“抑郁”、“危险因素”及其自由词的相关文献。在尽量全面地收集相关数据资料的基础上，根据纳排标准，并采用美国卫生保健质量和研究机构(agency for healthcare research and quality, AHRQ)的横断面研究评分标准来评价对所提取文献进行质量评价，将得分 > 4分的文献纳入研究，最后采用RevMan5.4对其进行Meta分析。结果：13篇文献符合纳入标准，累计观察人数6600例，经过筛查发生有抑郁的人数为1991例，根据异质性检验的结果选择相应效应模型进行数据合并，计算各危险因素合并比值比(OR)及其95%可信区间(CI)，经Meta分析结果显示。孕期抑郁的发生危险因素为：职业[OR = 3.54, 95%CI: 2.18~5.77, P < 0.001]、孕期负面事件[OR = 2.39, 95%CI: 1.90~3.00, P < 0.001]、家庭经济收入情况[OR = 2.12, 95%CI: 1.22~3.70, P = 0.008]、流产史[OR = 1.95, 95%CI: 1.40~2.71, P < 0.001]、抑郁史[OR = 3.38, 95%CI: 2.49~4.60, P < 0.001]、家庭关系[OR = 4.33, 95%CI: 3.25~5.76, P < 0.001]、对胎儿性别期待[OR = 3.13, 95%CI: 2.33~4.19, P < 0.001]是孕期抑郁症的危险因素。结论：现有证据表明，职业、孕期负面事件、家庭经济收入、流产史、抑郁史、家庭关系、期待胎儿性别均是孕期抑郁发生的危险因素，控制上述因素可以有效降低产妇孕期患抑郁症的风险，未来可从国家加强医疗保健的投入、家庭支持、医护人员加强宣教、转变孕产妇观念等方面来预防孕期抑郁的发生。
Objective: To explore the risk factors of pregnancy depression by systematic evaluation, and to provide the scientific basis for understanding and preventing the occurrence of pregnancy depression. Methods: A computer search was conducted on CNKI, Wanfang Database, VIP series database, PubMed, EMBASE, Web of Science, and other databases to retrieve the research literature on the influencing factors of the onset of depression during pregnancy published from the establishment of the database to May 31, 2023. The search terms included “pregnancy”, “depression”, “risk factors”, and their free words. Based on the fullest possible collection of relevant case data, based on inclusion and exclusion criteria, and using the Agency for Healthcare Research and Quality (AHRQ)To evaluate the quality of the extracted literatures. Literatures with scores greater than 4 points were included in the study. Finally, RevMan5.4 was used for meta-analysis. Results: There are 13 literatures that met the inclusion criteria, with a cumulative number of 6600 patients and 1991 patients with depressive symptoms after screening. According to the results of the heterogeneity test, the corresponding effect model was selected for data consolidation, and the combined odds ratio
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