The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis.
The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis.
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DOI：
10.1186/s12978-021-01209-5
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发表时间：
2021-07-28
影响因子：
3.4
通讯作者：
Sibbritt D
中科院分区：
文献类型：
--
作者：
Bedaso A;Adams J;Peng W;Sibbritt D
怀孕是一个深刻的身体和情绪变化的时期，也是精神疾病风险增加的时期。虽然加强社会支持是减少这种心理健康风险的常见建议，但尚未有系统的综述或荟萃分析研究社会支持与怀孕期间心理问题之间的关系。使用PRISMA检查表作为指南，对报告主要数据分析的相关同行评审文献进行系统性审查。对PubMed、Psych Info、MIDIRS、SCOPUS和CINAHL数据库进行了检索，以检索2000年至2019年期间发表的研究文章。采用Newcastle-Ottawa量表进行质量评价，采用STATA进行Meta分析。使用Q和I2统计量评价异质性。使用随机效应模型汇总估计值。使用漏斗图和Egger回归检验评估发表偏倚，并使用修剪和填充分析进行调整。在识别的3760篇文章中，67篇文章（64，449名孕妇）是当前系统性综述和荟萃分析的一部分。在总共67篇文献中，分别有22篇和45篇文献被纳入叙述性分析和荟萃分析。从纳入叙述性分析的所有文章中，有20篇文章报告了低社会支持与妊娠期间发生心理健康问题（即抑郁、焦虑和自我伤害）的风险之间的显著关系。根据随机效应模型的结果，调整发表偏倚后，低社会支持的合并优势比（POR）为AOR：1.18（95% CI：1.01，1.41）对于研究低社会支持与产前抑郁之间的关系的研究，AOR：1.97（95%CI：1.34，2.92）的研究，探讨社会支持和产前焦虑之间的关系。低社会支持与怀孕期间抑郁，焦虑和自我伤害的风险显着相关。政策制定者和从事产妇保健工作的人应考虑制定有针对性的社会支助方案，以帮助减少孕妇的心理健康问题。在线版本包含补充材料，可通过10.1186/s12978-021-01209-5获得。怀孕是育龄妇女的一件大事。它是由荷尔蒙变化补充，可以代表一个时间的风险增加发生精神疾病，如抑郁症，焦虑和自我伤害。为孕妇提供良好的社会支持可减少这一风险，并预防妊娠并发症和不良分娩结果。然而，没有系统的回顾和/或荟萃分析探讨了社会支持和心理疾病（抑郁，焦虑，自我伤害）之间的关联在孕妇。因此，本系统综述和荟萃分析旨在研究社会支持与妊娠期间精神疾病（焦虑，抑郁和自我伤害）之间的关联。该综述从PubMed，Psych Info，MIDIRS，SCOPUS和CINAHL数据库中识别出67篇相关文章，涉及64，449名孕妇。在总共67篇文章中，22篇文章被纳入叙述性综述，45篇文章被纳入荟萃分析。在叙事合成中纳入的研究中，大多数报告了低社会支持与产前抑郁，产前焦虑和怀孕期间自我伤害之间的显着正相关。此外，荟萃分析的汇总估计值显示，低社会支持与产前抑郁（AOR：1.18（95%CI：1.01，1.41））和产前焦虑（AOR：1.97（95%CI：1.34，2.92））显著正相关。因此，孕产妇保健专业人员需要与孕妇讨论她们获得的社会支持的水平和来源。产妇保健专业人员也可能需要考虑鼓励孕妇的社会网络，以改善所提供的社会支持。政策制定者和从事产妇保健工作的人应考虑制定有针对性的社会支助方案，以帮助减少孕妇的心理健康问题。在线版本包含补充材料，可通过10.1186/s12978-021-01209-5获得。
Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy. The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle–Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I2 statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis. From the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety. Low social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women. The online version contains supplementary material available at 10.1186/s12978-021-01209-5. Pregnancy is a significant event for reproductive-age women. It is supplemented by hormonal changes and can represent a time of increased risk for the occurrence of mental illness like depression, anxiety and self-harm. Providing good social support for the pregnant mother reduce this risk and prevent pregnancy complication and adverse birth outcome. However, no systematic review and/or meta-analysis has explored the associations between social support and mental illness (depression, anxiety, self-harm) among pregnant women. Therefore, this systematic review and meta-analysis aimed to examine the association between social support and mental illness (anxiety, depression, and self-harm) during pregnancy. The review identified 67 relevant articles with 64,449 pregnant women, from PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database. Of the total 67 articles, 22 articles included in the narrative review and 45 articles included in the meta-analysis. Among studies included in the narrative synthesis, a majority of them reported significant positive associations between low social support and antenatal depression, antenatal anxiety and self-harm during pregnancy. Further, the pooled estimates of the meta-analysis show that low social support had a significant positive association with antenatal depression (AOR: 1.18 (95% CI: 1.01, 1.41)) and antenatal anxiety (AOR: 1.97 (95% CI: 1.34, 2.92)). Therefore, maternal health professionals need to have discussions with pregnant women regarding the level and source of social support they receive. Maternal health professionals may also need to consider encouraging the social network of pregnant women to improve social support being given. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women. The online version contains supplementary material available at 10.1186/s12978-021-01209-5.
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