Prenatal maternal posttraumatic stress disorder as a risk factor for adverse birth weight and gestational age outcomes: A systematic review and meta-analysis.
Prenatal maternal posttraumatic stress disorder as a risk factor for adverse birth weight and gestational age outcomes: A systematic review and meta-analysis.
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DOI：
10.1016/j.jad.2021.08.079
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发表时间：
2021-12-01
影响因子：
6.6
通讯作者：
Leeman, Lawrence
中科院分区：
文献类型：
--
作者：
Sanjuan, Pilar M.;Fokas, Kathryn;Tonigan, J. Scott;Henry, Melissa C.;Christian, Korinna;Rodriguez, Andrea;Larsen, Jessica;Yonke, Nicole;Leeman, Lawrence
虽然没有常规评估，但产前创伤后应激障碍（PTSD）与母亲心理健康状况不佳和母婴关系密切相关。产前创伤后应激障碍也可能与出生体重和胎龄有关，但这一点尚不清楚。本系统综述和荟萃分析调查了产前创伤后应激障碍与低出生体重（LBW）或早产（PTB）风险（二分医学定义的截断值）或与出生体重（BW）或胎龄（GA）（连续变量）的关系。在Web of Science、MedLine、PubMed和PsychInfo进行了全面的文献检索。根据流行病学观察性研究的meta分析（MOOSE）指南收集和处理数据。采用纽卡斯尔-渥太华质量评估量表评估研究质量。用随机效应模型估计合并效应大小（连续相关性和二分类结果的优势比）。16项研究51,470名参与者（产前PTSD 8%）被纳入4项荟萃分析。产妇产前PTSD与LBW （OR = 1.96; 95% CI, 1.26, 3.03; P = 0.003）、PTB (OR = 1.42 （95% CI, 1.16, 1.73; P = 0.001）和GA降低（r = - 0.04; 95% CI, - 0.06, - 0.01; P = 0.002）的风险较高相关。不同的研究设计，不同的创伤后应激障碍评估实践，以及一小部分研究被注意到。研究结果表明，产前创伤后应激障碍增加了LBW、PTB和GA降低的风险。产前创伤后应激障碍对新生儿身体伤害的证据为增加产前创伤后应激障碍筛查和确定有效的产前干预措施以改善母婴结局提供了强有力的依据。
Although not routinely assessed, prenatal posttraumatic stress disorder (PTSD) is associated with poor maternal mental health and mother-infant bonding. Prenatal PTSD may also be associated with birth weight and gestational age outcomes, but this remains unclear. This systematic review and meta-analysis investigated the association of prenatal PTSD with risk of low birth weight (LBW) or preterm birth (PTB) (dichotomous medically-defined cut-offs) or with birth weight (BW) or gestational age (GA) (continuous variables). A comprehensive literature search was conducted in Web of Science, MedLine, PubMed, and PsychInfo. Data were collected and processed according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Study quality was assessed with the Newcastle-Ottowa Quality Assessment Scale. Pooled effect sizes were estimated with random-effects models (correlation for continuous and odds ratios for dichotomous outcomes). Sixteen studies with 51,470 participants (prenatal PTSD 8%) were included in 4 meta-analyses. Maternal prenatal PTSD was associated with higher risks of LBW (OR = 1.96; 95% CI, 1.26, 3.03; P = .003), PTB (OR = 1.42 (95% CI, 1.16, 1.73; P = .001), and reduced GA (r = −0.04; 95% CI, −0.06, −0.01; P = .002). Different designs across studies, variety of PTSD assessment practices, and a small pool of studies were noted. Findings suggest prenatal PTSD presents increased risks of LBW, PTB, and reduced GA. Evidence of physical harm to neonates from prenatal PTSD provides a powerful rationale to increase prenatal PTSD screening and identify effective prenatal interventions to improve maternal and child outcomes.
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