Antenatal risk factors for postpartum depression: a synthesis of recent literature
Antenatal risk factors for postpartum depression: a synthesis of recent literature
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DOI：
10.1016/j.genhosppsych.2004.02.006
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发表时间：
2004-07-01
影响因子：
7
通讯作者：
Stewart, DE
中科院分区：
文献类型：
--
作者：
Robertson, E;Grace, S;Stewart, DE
产后非精神病性抑郁症是最常见的分娩并发症，影响约10-15%的妇女，因此，是影响妇女及其家庭的一个相当大的健康问题。这篇系统性综述综合了最近有关产前风险因素的文献，这些因素与这种疾病的发生有关。使用特定的纳入标准和检索词检索与医学、心理学和社会科学文献相关的数据库，以识别检查产后抑郁症产前风险因素的研究。为了综合目前的调查结果，确定了研究报告并进行了严格的评价。检索结果确定了对14，000多名受试者进行的两项主要荟萃分析，以及随后更新的大规模临床研究。然后根据Cohen定义的效应量总结这些研究的结果。对超过14，000名受试者进行的荟萃分析以及随后对近10，000名受试者进行的研究发现，以下因素是产后抑郁症的最强预测因素：怀孕期间的抑郁，怀孕期间的焦虑，怀孕期间或产褥期早期经历紧张的生活事件，低水平的社会支持以及既往抑郁症史。对文献的批判性评估揭示了一些需要在未来研究中解决的方法和知识差距。这些措施包括审查社会经济地位较低的妇女的具体风险因素，与少女母亲有关的风险因素，以及使用适当的工具评估产后抑郁症，供不同文化群体使用。(C)2004年爱思唯尔公司All rights reserved.
Postpartum nonpsychotic depression is the most common complication of childbearing, affecting approximately 10-15% of women and, as such, represents a considerable health problem affecting women and their families. This systematic review provides a synthesis of the recent literature pertaining to antenatal risk factors associated with developing this condition. Databases relating to the medical, psychological, and social science literature were searched using specific inclusion criteria and search terms, in order to identify studies examining antenatal risk factors for postpartum depression. Studies were identified and critically appraised in order to synthesize the current findings. The search resulted in the identification of two major meta-analyses conducted on over 14,000 subjects, as well as newer subsequent large-scale clinical studies. The results of these studies were then summarized in terms of effect sizes as defined by Cohen. The findings from the meta-analyses of over 14,000 subjects, and subsequent studies of nearly 10,000 additional subjects found that the following factors were the strongest predictors of postpartum depression: depression during pregnancy, anxiety during pregnancy, experiencing stressful life events during pregnancy or the early puerperium, low levels of social support, and a previous history of depression. Critical appraisal of the literature revealed a number of methodological and knowledge gaps that need to be addressed in future research. These include examining specific risk factors in women of lower socioeconomic status, risk factors pertaining to teenage mothers, and the use of appropriate instruments assessing postpartum depression for use within different cultural groups. (C) 2004 Elsevier Inc. All rights reserved.