中国高龄产妇产后抑郁检出率的Meta分析

BackgroundWith the rapid development of economy and the change of fertility concept in modern populationcoupled with the full liberalization of the “two-child” and “three-child” policiesthe number of advanced maternal age is increasing year by year. Compared with appropriate maternal ageadvanced maternal age is more likely to suffer from depressive symptoms due to personalfamilyworkand other reasons. ObjectiveTo systematically evaluate the detection rate of postpartum depression in advanced maternal age≥ 35 years at delivery in China to provide relevant evidence for early prevention and intervention. MethodsCNKIWanfangVIPCBMPubMedCochrane LibraryEmbase and Web of Science were searched for articles on the detection rate of postpartum depression in advanced maternal age in China by combining subject terms and free terms from inception to July 2023. The process of literature screeningdata extraction and quality assessment were carried out by two researchers independently. Stata 16.0 software was used for data analysis. ResultsA total of 21 studies were includedwith a total sample size of 5 163. The results of Meta-analysis showed that the overall detection rate of postpartum depression in advanced maternal age in China was 20.0%95%CI=17.4%-22.6%. The subgroup analysis revealed that the detection rate of postpartum depression was 19.5%95%CI=13.8%-25.3% in women < 40 years old40.3% 95%CI=11.4%-69.3% in women ≥ 40 years old19.7%95%CI=11.7%-27.7% in women with high school education level or higher30.7%95%CI=19.1%-42.3% in women with high school education level or lower21.1%95%CI=14.4%-27.9% in primipara16.2%95%CI=12.9%-19.6% in multipara16.4%95%CI=12.2%-20.6% in natural childbirth 27.8%95%CI=20.9%-34.8% in cesarean section20.7%95%CI=15.6%-25.8% in women with male newborn and 27.3%95%CI=20.5%-34.0% in women with female newborn there were 38.7%95%CI=22.6%-54.8% women with pregnancy complications11.7%95%CI=7.6%-15.8% women without pregnancy complications29.5%95%CI=17.9%- 41.1% women with adverse pregnancy and childbirth history27.7%95%CI=16.6%-38.8% women without adverse pregnancy and childbirth history18.0%95%CI=16.5%-19.4% published the year before 202019.5%95%CI=18.0%- 21.0% published the year after 202020.4%95%CI=18.2%-22.6% in the north and 18.2%95%CI=17.0%-19.4% in the south20.0%95%CI=18.5%-21.5% in the Edinburgh Postnatal Depression ScaleEPDS score ≥ 13 and 16.9% 95%CI=15.2%-18.5% in the EPDS score ≥ 10. The Egger's testt=1.76P=0.095 and the Begg's testZ=1.48 P=0.147 indicated no significant publication bias. ConclusionThe detection rate of postpartum depression is higher for advanced maternal age in Chinaincluding women ≥ 40 years oldwith high school education level or lowerprimipara cesarean sectionfemale newbornpregnancy complications and adverse pregnancy and childbirth historypublish year after 2020areas of the northEPDS score ≥ 13attention should be paid to the psychological status of advanced maternal ageand corresponding prevention and intervention measures should be formulated.