Identifying the women at risk of antenatal anxiety and depression: A systematic review.
Identifying the women at risk of antenatal anxiety and depression: A systematic review.
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DOI：
10.1016/j.jad.2015.11.014
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发表时间：
2016-02
影响因子：
6.6
通讯作者：
Pariante CM
中科院分区：
文献类型：
--
作者：
Biaggi A;Conroy S;Pawlby S;Pariante CM
怀孕是焦虑和抑郁症发展的脆弱性增加的时间。本系统综述旨在确定产前焦虑和抑郁发作的主要危险因素。使用PubMed、PsychINFO和科克伦图书馆进行系统的文献分析。如果原始论文以英语撰写并在2003年1月1日至2015年8月31日期间发表，则纳入原始论文，而无论发表日期如何，均查阅文献综述和荟萃分析。最终选出了97篇论文。与产前抑郁或焦虑相关的最相关因素是：缺乏伴侣或社会支持;虐待或家庭暴力史;个人精神疾病史;计划外或意外怀孕;生活中的不良事件和高感知压力;现在/过去的怀孕并发症;以及流产。该综述不包括荟萃分析，荟萃分析可能增加了关于每个风险因素的差异影响的额外信息。此外，它没有具体研究可能影响不同类型焦虑症的因素，或者从怀孕到产后期间抑郁或焦虑的复发或持续。研究结果显示了产前抑郁和焦虑的复杂病因。为了促进母亲和婴儿的长期福祉，应普遍采用筛查工具来确定怀孕期间有焦虑和抑郁风险的妇女，而对特定风险因素的了解可能有助于创建针对高风险妇女的筛查工具。产后抑郁症和焦虑症有多因素病因。已经确定了六种不同的风险因素来源。缺乏支持已被确定为最大的风险因素。目前/过去的虐待也被发现是一个重要的预测因素。
Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk. Antenatal depression and anxiety have a multi-factorial aetiology. Six different sources of risk factors have been identified. Lack of support has been identified as the strongest risk factor. Current/past abuse has also been found to be a significant predictor.