我国妊娠人群产后创伤后应激障碍患病率的Meta分析-东南大学学报医学版

我国妊娠人群产后创伤后应激障碍患病率的Meta分析

单位：滨海县人民医院产科, 江苏盐城 224500

分类号：R714.1; R749.5

出版年·卷·期（页码）：2023·42·第二期（299-304）

摘要：

目的:系统评价中国妊娠人群产后创伤后应激障碍患病率。方法:计算机检索中国期刊全文数据库(CNKI)、万方数据知识服务平台、中国生物医学文献服务系统(SinoMed)、PubMed、Web of Science、The Cochrane Library等数据库,检索中国妊娠人群产后创伤后应激障碍患病率的相关文献,检索时间从建立数据库至2022年7月8日。由2名研究者独立筛选文献、提取相关资料,在评价纳入研究的偏倚风险后,采用R 4.1.1软件进行Meta分析。结果:共纳入16项研究,包括1 054例产后创伤后应激障碍患者。Meta分析显示,妊娠人群产后创伤后应激障碍患病率为10%(95%CI 7%~13%);在早产或过期产的产后人群中,创伤后应激障碍患病率为21%(95%CI 7%~35%)。结论:中国妊娠人群产后创伤后应激障碍患病率较高,尤其是高危人群。建议产前及早发现高危人群,进行适当护理干预,改善产妇心理健康状态。

Objective: To systematically evaluate the incidence of postpartum post-traumatic stress disorder in Chinese pregnant population. Methods: The databases including China National Knowledge Infrastructure(CNKI), Wanfang Data, SinoMed, PubMed, Web of Science, The Cochrane Library and other databases were searched from inception to July 8, 2022 to extract the data on the incidence of postpartum post-traumatic stress disorder in Chinese pregnant population.Two researchers screened the literature, analyzed these data, and evaluated the bias risk independently. R 4.1.1 software was used for Meta analysis. Results: A total of 16 studies were included, including 1 054 patients with post-traumatic stress disorder. Meta analysis showed that the incidence of post-traumatic stress disorder was 10%(95%CI 7%-13%)in the postpartum population. The prevalence of post-traumatic stress disorder was 21%(95% CI 7%-35%) in the postpartum population with preterm or late delivery. Conclusion: The prevalence of post-traumatic stress disorder in Chinese pregnant population is high, especially in high-risk groups. It is recommended that high-risk groups should be identified early before delivery, and appropriate nursing interventions should be carried out to improve maternal mental health.

参考文献：

[1] DIKMEN-YILDIZ P,AYERS S,PHILLIPS L.Depression,anxiety,PTSD and comorbidity in perinatal women in Turkey:A longitudinal population-based study[J].Midwifery,2017,55:29-37.
[2] VIGNATO J,GEORGES J M,BUSH R A,et al.Post-traumatic stress disorder in the perinatal period:A concept analysis[J].J Clin Nurs,2017,26(23-24):3859-3868.
[3] FERGUSON R.Recognizing postpartum posttraumatic stress disorder[J].Nursing,2018,48(4):14.
[4] GARTHUS-NIEGEL S,HORSCH A,VON SOEST T,et al.Posttraumatic stress symptoms following childbirth:associations with prenatal attachment in subsequent pregnancies[J].Arch Womens Ment Health,2020,23(4):547-555.
[5] SLADE P,MURPHY A,HAYDEN E.Identifying post-traumatic stress disorder after childbirth[J].BMJ,2022,377:e67659.
[6] SCHWAB W,MARTH C,BERGANT A M.Post-traumatic stress disorder post partum:the impact of birth on the prevalence of post-traumatic stress disorder(PTSD) in multiparous women[J].Geburtshilfe Frauenheilkd,2012,72(1):56-63.
[7] MARTÍNEZ-VAZQUEZ S,RODRÍGUEZ-ALMAGRO J,HERNÁNDEZ-MARTÍNEZ A,et al.Long-term high risk of postpartum post-traumatic stress disorder(PTSD) and associated factors[J].J Clin Med,2021,10(3):488.
[8] ANDRIOTTI T,RANJIT A,HAMLIN L,et al.Psychiatric conditions during pregnancy and postpartum in a universally insured American population[J].Mil Med,2022,187(7-8):e795-e801.
[9] VERREAULT N,DA C D,MARCHAND A,et al.PTSD following childbirth:a prospective study of incidence and risk factors in Canadian women[J].J Psychosom Res,2012,73(4):257-263.
[10] 聂小菲,刘昕宇,祁雨帆,等.产后创伤后应激障碍评估工具的研究进展[J].护理学杂志,2021,36(11):98-101.
[11] DE GRAAFF L F,HONIG A,VAN PAMPUS M G,et al.Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences:a systematic review[J].Acta Obstet Gynecol Scand,2018,97(6):648-656.
[12] 张兰,刘颖,郭娜菲,等.围产期创伤后应激障碍干预策略研究进展[J].中华现代护理杂志,2020,26(27):3844-3849.
[13] 黄凌,樊雅静,丁瑾赟,等.护士主导下同伴支持对初产妇产后创伤后应激障碍的干预效果[J].中国实用护理杂志,2020,36(29):2279-2283.
[14] 沈子晨,杨正霞,江海娇,等.产后创伤后应激障碍现状及影响因素分析[J].现代医药卫生,2022,38(10):1682-1686,1692.
[15] 王梅芳,王相茹,郑文凯,等.产妇产后不同时期应激障碍现状及其影响因素分析[J].中华现代护理杂志,2022,28(14):1902-1907.
[16] LIU Y,ZHANG L,GUO N,et al.Postpartum depression and postpartum post-traumatic stress disorder:prevalence and associated factors[J].BMC Psychiatry,2021,21(1):487.
[17] 陈彦芳,谢日华,李萌,等.产后创伤后应激障碍危险因素的调查分析[J].护理学杂志,2021,36(10):14-16,29.
[18] 许贵如,邱萍萍,王小燕,等.产妇PTSD的发生率及影响因素研究[J].福建医科大学学报(社会科学版),2021,22(1):14-19.
[19] 叶芳,高新营,林荭,等.产妇新型冠状病毒肺炎疫情相关心理应激的调查与分析[J].上海医学,2021,44(7):491-495.
[20] 张兰,刘颖,李俊英,等.上海市2552名产妇产后创伤后应激障碍现状及影响因素分析[J].中华现代护理杂志,2021,27(31):4298-4303.
[21] 王相茹,王梅芳,李小妹.产妇神经质人格与产后创伤后应激障碍的相关性研究[J].解放军护理杂志,2020,37(1):51-55.
[22] 吴琴,祝艳,周翠华.产妇产后创伤后应激障碍影响因素分析[J].医学信息,2020,33(14):129-130,139.
[23] 刘婷婷,费英俊,李月.剖宫产后创伤后应激障碍调查及其影响因素分析[J].中国医师杂志,2020,22(5):714-717,722.
[24] 甘泉,周冬,程若沁.产后创伤后应激障碍的相关因素分析[J].中华行为医学与脑科学杂志,2019,28(11):1025-1029.
[25] 杨涵.产后情绪障碍及其影响因素探究[D].武汉:武汉大学,2019.
[26] 许超,张迪.住院早产儿母亲的创伤后应激障碍症状阳性率及影响因素分析[J].武汉大学学报(医学版),2018,39(6):974-977,981.
[27] 彭娅.产后创伤后应激障碍现状及其影响因素的研究[D].沈阳:中国医科大学,2016.
[28] 龙周婷.产后抑郁预测因素的纵向研究[D].济南:山东大学,2014.
[29] 夏宏伟,闫学明.孕中晚期心理及其对产后应激状况影响研究[J].中国健康心理学杂志,2012,20(6):841-843.
[30] YILDIZ P D,AYERS S,PHILLIPS L.The prevalence of posttraumatic stress disorder in pregnancy and after birth:a systematic review and meta-analysis[J].J Affect Disord,2017,208:634-645.
[31] CHEN Y,YANG X,GUO C,et al.Prevalence of post-traumatic stress disorder following caesarean section:a systematic review and meta-analysis[J].J Womens Health(Larchmt),2020,29(2):200-209.
[32] HERNÁNDEZ-MARTÍNEZ A,RODRÍGUEZ-ALMAGRO J,MOLINA-ALARCÓN M,et al.Postpartum post-traumatic stress disorder:associated perinatal factors and quality of life[J].J Affect Disord,2019,249:143-150.
[33] LOPEZ U,MEYER M,LOURES V,et al.Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia:a prospective cohort study[J].Health Qual Life Outcomes,2017,15(1):118.
[34] AYERS S,BOND R,BERTULLIES S,et al.The aetiology of post-traumatic stress following childbirth:a meta-analysis and theoretical framework[J].Psychol Med,2016,46(6):1121-1134.
[35] MALAJU M T,ALENE G D,BISETEGN T A.Longitudinal mediation analysis of the factors associated with trajectories of posttraumatic stress disorder symptoms among postpartum women in Northwest Ethiopia:application of the Karlson-Holm-Breen(KHB) method[J].PLoS One,2022,17(4):e266399.
[36] 张跃奇,王媛,李娜.血清皮质醇、5-羟色胺水平与创伤后应激障碍临床症状的相关性研究[J].东南大学学报(医学版),2020,39(5):651-654.
[37] 顾晓霞,高梦洁,丁波.椎管内分娩镇痛产时发热影响因素和干预对策的文献综述[J].东南大学学报(医学版),2021,40(6):865-868.
[38] KAHALON R,PREIS H,BENYAMINI Y.Mother-infant contact after birth can reduce postpartum post-traumatic stress symptoms through a reduction in birth-related fear and guilt[J].J Psychosom Res,2022,154:110716.
[39] 高长胜,黄符香,宋歌,等.艾司氯胺酮对高龄产妇剖宫产术后抑郁和恢复质量的影响[J].中国新药与临床杂志,2022,41(9):535-539.
[40] 彭娅,赵海平.产后创伤后应激障碍研究进展[J].护理研究,2017,31(3):274-276.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录