Postnatal Depression Risk Factors: An Overview of Reviews to Inform COVID-19 Research, Clinical, and Policy Priorities.
Postnatal Depression Risk Factors: An Overview of Reviews to Inform COVID-19 Research, Clinical, and Policy Priorities.
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DOI：
10.3389/fgwh.2020.577273
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Klein L
中科院分区：
文献类型：
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作者：
Doyle FL;Klein L
COVID-19 大流行对正常生活的干扰预计将加剧现有的心理健康问题风险因素。对于在危机期间分娩的女性尤其是那些有产后抑郁症风险的女性来说尤其如此。孕产妇产后抑郁症已被确定为对孕产妇和儿童福祉产生深远影响的公共卫生问题。以往危机（例如地震、恐怖袭击）的证据表明，危机严重影响孕产妇心理健康和一些围产期健康结果。因此，本文的目的是进行审查，以确定孕产妇产后抑郁症的既定风险因素，并根据已确定的风险因素，提出关于 COVID-19 危机是否可能增加或减少产后抑郁症发生率的循证假设。 2020 年 5 月至 6 月期间，使用以下关键词搜索了多个数据库以查找综述论文（即系统综述、荟萃分析、定性综合）：抑郁症、围产期、产后、产后、系统、综述、预测因子。风险因素与证据强度指标（即效应大小、定性编码）一起提取。针对风险因素对 COVID-19 危机影响的敏感性进行了严格评估。据推测，减少 COVID-19 传播所必需的几项卫生政策（例如规定的限制）可能会同时影响一系列已知的风险因素，并使更多女性面临更高的产后抑郁症风险。例如，极有可能加剧恶化的因素包括： 感知到的社会支持度较低；怀孕期间或之前遭受创伤事件；怀孕期间发生的重大生活事件；以及与照顾孩子相关的高压力。讨论了未来的研究和政策影响，包括政策制定者如何尝试改善当前 COVID-19 大流行后已确定的产后抑郁症风险因素。
The disruption of normal life due to the COVID-19 pandemic is expected to exacerbate extant risk factors for mental health problems. This may be particularly true for women who give birth during the crisis, especially those at risk for postnatal depression. Maternal postnatal depression has been identified as a public health issue with profound impacts on maternal and child well-being. Evidence from previous crises (e.g., earthquakes, terrorist attacks) has shown that crises significantly impact maternal mental health and some perinatal health outcomes. The aims of this paper were therefore to conduct a review to identify the established risk factors for maternal postnatal depression, and generate evidence-based hypotheses about whether the COVID-19 crisis would likely increase or decrease postnatal depression rates based on the identified risk factors. Several databases were searched during May-June 2020 for review papers (i.e., systematic reviews, meta-analyses, qualitative syntheses) using the following keywords: Depression, perinatal, postnatal, postpartum, systematic, review, predictors. Risk factors were extracted in conjunction with indicators for their strength of evidence (i.e., effect sizes, qualitative coding). Risk factors were critically evaluated in relation to their susceptibility to the impacts of the COVID-19 crisis. It was hypothesized that several health policies that were necessary to reduce the spread of COVID-19 (e.g., required restrictions) may be simultaneously impacting a range of these known risk factors and placing a larger number of women at heightened risk for postnatal depression. For instance, factors at a strong risk of being exacerbated include: Perceived low social support; exposure to traumatic events during or prior to pregnancy; significant life events occurring during pregnancy; and high stress associated with care of children. Future research and policy implications are discussed, including how policy makers could attempt to ameliorate the identified risk factors for postnatal depression following the current COVID-19 pandemic.