中国全科医学 ›› 2024, Vol. 27 ›› Issue (11): 1363-1369.DOI: 10.12114/j.issn.1007-9572.2023.0635

• 论著·医学循证 • 上一篇    下一篇

中国高龄产妇产后抑郁检出率的Meta分析

李龙1, 安雪梅2,*(), 张杰1, 黄琳瑜1, 张兴玲1   

  1. 1.610075 四川省成都市,成都中医药大学护理学院
    2.610032 四川省成都市,成都中医药大学附属医院护理部
  • 收稿日期:2023-08-20 修回日期:2023-11-20 出版日期:2024-04-15 发布日期:2024-01-23
  • 通讯作者: 安雪梅

  • 作者贡献:李龙负责研究构思和设计、数据提取和论文撰写;张杰负责数据分析,并进行文献质量评价;黄琳瑜、张兴玲负责文献质量评价;安雪梅负责文章修改和质量控制,对文章整体负责。
  • 基金资助:
    四川省科技厅科研项目(2023JDKP0092)

The Detection Rate of Postpartum Depression in Advanced Maternal Age in China: a Meta-analysis

LI Long1, AN Xuemei2,*(), ZHANG Jie1, HUANG Linyu1, ZHANG Xingling1   

  1. 1. Nursing College of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
    2. Department of Nursing, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610032, China
  • Received:2023-08-20 Revised:2023-11-20 Published:2024-04-15 Online:2024-01-23
  • Contact: AN Xuemei

摘要: 背景 随着我国经济的高速发展和现代人生育观念的转变,高龄产妇的数量正在逐年增加。相较于适龄产妇,高龄产妇更可能因自身、家庭、工作等原因产生抑郁症状。 目的 系统评价我国高龄产妇(分娩时年龄≥35岁)产后抑郁检出率,为早期预防和干预提供相关依据。 方法 在中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库和PubMed、Cochrane Library、Embase、Web of Science数据库中以主题词和自由词相结合的方式检索与中国高龄产妇产后抑郁检出率相关的文献,检索时限为数据库建库至2023年7月。文献筛选、资料提取和质量评价过程由2名研究员独立进行。使用Stata 16.0软件进行数据分析。 结果 共纳入21篇文献,样本量合计5 163例。Meta分析结果显示,我国高龄产妇产后抑郁总检出率为20.0%(95%CI=17.4%~22.6%)。亚组分析结果显示,年龄<40岁高龄产妇产后抑郁检出率为19.5%(95%CI=13.8%~25.3%),≥40岁为40.3%(95%CI=11.4%~69.3%);文化程度高中以上为19.7%(95%CI=11.7%~27.7%),高中及以下为30.7%(95%CI=19.1%~42.3%);初产妇为21.1%(95%CI=14.4%~27.9%),经产妇为16.2%(95%CI=12.9%~19.6%);自然分娩为16.4%(95%CI=12.2%~20.6%),剖宫产为27.8%(95%CI=20.9%~34.8%);新生儿性别男性为20.7%(95%CI=15.6%~25.8%),女性为27.3%(95%CI=20.5%~34.0%);有妊娠并发症为38.7%(95%CI=22.6%~54.8%),无妊娠并发症为11.7%(95%CI=7.6%~15.8%);有不良孕产史为29.5%(95%CI=17.9%~41.1%),无不良孕产史为27.7%(95%CI=16.6%~38.8%);发表年份为2020年以前为18.0%(95%CI=16.5%~19.4%),发表年份为2020年及以后为19.5%(95%CI=18.0%~21.0%);调查地区北方为20.4%(95%CI=18.2%~22.6%),南方为18.2%(95%CI=17.0%~19.4%);爱丁堡产后抑郁量表(EPDS)评分≥13分为20.0%(95%CI=18.5%~21.5%),≥10分为16.9%(95%CI=15.2%~18.5%)。Egger's检验(t=1.76,P=0.095)和Begg's检验(Z=1.48,P=0.147)提示不存在明显发表偏倚。 结论 我国高龄产妇产后抑郁检出率较高(20.0%),其中年龄≥40岁、文化程度高中及以下、初产妇、剖宫产、新生儿性别为女性、有妊娠并发症、有不良孕产史、发表年份为2020年及以后、调查地区为北方、EPDS评分≥13分的高龄产妇产后抑郁检出率较高,应重视以上高龄产妇的心理状况,并制定相应的预防和干预措施。

关键词: 抑郁症,产后, 产妇, 高龄, 检出率, Meta分析, 中国

Abstract:

Background

With the rapid development of economy and the change of fertility concept in modern population, the number of advanced maternal age is increasing year by year. Compared with appropriate maternal age, advanced maternal age is more likely to suffer from depressive symptoms due to personal, family, work, and other reasons.

Objective

To systematically evaluate the detection rate of postpartum depression in advanced maternal age (≥35 years at delivery) in China to provide relevant evidence for early prevention and intervention.

Methods

CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science were searched for articles on the detection rate of postpartum depression in advanced maternal age in China by combining subject terms and free terms from inception to July 2023. The process of literature screening, data extraction and quality assessment were carried out by two researchers independently. Stata 16.0 software was used for data analysis.

Results

A total of 21 studies were included, with a total sample size of 5 163. The results of Meta-analysis showed that the overall detection rate of postpartum depression in advanced maternal age in China was 20.0% (95%CI=17.4%-22.6%). The subgroup analysis revealed that the detection rate of postpartum depression was 19.5% (95%CI=13.8%-25.3%) in women < 40 years old, 40.3% (95%CI=11.4%-69.3%) in women ≥ 40 years old, 19.7% (95%CI=11.7%-27.7%) in women with high school education level or higher, 30.7% (95%CI=19.1%-42.3%) in women with high school education level or lower, 21.1% (95%CI=14.4%-27.9%) in primipara, 16.2% (95%CI=12.9%-19.6%) in multipara, 16.4% (95%CI=12.2%-20.6%) in natural childbirth, 27.8% (95%CI=20.9%-34.8%) in cesarean section, 20.7% (95%CI=15.6%-25.8%) in women with male newborn and 27.3% (95%CI=20.5%-34.0%) in women with female newborn; there were 38.7% (95%CI=22.6%-54.8%) women with pregnancy complications, 11.7% (95%CI=7.6%-15.8%) women without pregnancy complications, 29.5% (95%CI=17.9%-41.1%) women with adverse pregnancy and childbirth history, 27.7% (95%CI=16.6%-38.8%) women without adverse pregnancy and childbirth history, 18.0% (95%CI=16.5%-19.4%) published the year before 2020, 19.5% (95%CI=18.0%-21.0%) published the year after 2020, 20.4% (95%CI=18.2%-22.6%) in the north and 18.2% (95%CI=17.0%-19.4%) in the south, 20.0% (95%CI=18.5%-21.5%) in the Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13 and 16.9% (95%CI=15.2%-18.5%) in the EPDS score ≥ 10. The Egger's test (t=1.76, P=0.095) and the Begg's test (Z=1.48, P=0.147) indicated no significant publication bias.

Conclusion

The detection rate of postpartum depression is higher for advanced maternal age in China, including women ≥ 40 years old, with high school education level or lower, primipara, cesarean section, female newborn, pregnancy complications and adverse pregnancy and childbirth history, publish year after 2020, areas of the north, EPDS score ≥ 13, attention should be paid to the psychological status of advanced maternal age, and corresponding prevention and intervention measures should be formulated.

Key words: Depression, postpartum, Maternal, Advanced age, Detection rate, Meta-analysis, China