初产妇产后抑郁影响因素Meta分析

Influencing Factors of Postpartum Depression in Primiparas: A Meta-Analysis

摘要: 目的：采用Meta分析的方法系统探究初产妇产后抑郁的影响因素。方法：计算机检索中国知网、维普、万方医学网、PubMed、Embase、Cochrane Library、Web of Science、CBM八大数据库中有关初产妇产后抑郁影响因素的研究，检索时限从建库至2025年6月，对纳入的影响因素采用RevMan 5.4进行统计学分析。结果：共纳入17篇文献，其中包括14篇横断面研究和3篇病例对照研究。总样本量为10,647例。结果显示，产后抑郁的影响因素为社会支持[OR = 1.43, 95%CI (1.01, 2.01)]、文化程度[OR = 2.38, 95%CI (1.91, 2.96)]、年龄[OR = 2.2, 95%CI (1.42, 4.88)]、分娩方式[OR = 3.11, 95%CI (1.92, 5.04)]、家庭关系[OR = 1.56, 95%CI (1.07, 2.28)]、新生儿性别[OR = 2.89, 95%CI (1.57, 5.31)]、新生儿体质量[OR = 2.44,95%CI (1.63, 3.67)]、非计划妊娠[OR = 4.18, 95%CI (1.48, 11.80)]。敏感性分析结果显示，睡眠质量[OR = 1.98, 95%CI = (1.41, 2.79)]、分娩方式[OR = 4.27, 95%CI = (3.09, 5.91)]、家庭关系[OR = 1.41, 95%CI = (1.23, 1.60)]、新生儿性别[OR = 3.25, 95%CI = (1.51, 6.98)]、产前焦虑[OR = 2.10, 95%CI = (1.55, 2.85)]和非计划妊娠[OR = 6.95, 95%CI = (3.85, 12.54)]是初产妇产后抑郁的影响因素(P均<0.01)。结论：社会支持、文化程度、年龄、分娩方式、家庭关系、新生儿性别、新生儿体质量、非计划妊娠、睡眠质量和产前焦虑是初产妇产后抑郁的影响因素，在临床工作中应特别关注。

Abstract: Objective: To systematically explore the influencing factors of postpartum depression in primiparas using meta-analysis. Methods: A computerized search was conducted in eight databases, including CNKI, VIP, Wanfang Medical Network, PubMed, Embase, Cochrane Library, Web of Science, and CBM, for studies on the influencing factors of postpartum depression in primiparas. The search period was from the establishment of the databases to June 2025. The included influencing factors were statistically analyzed using RevMan 5.4. Results: A total of 17 articles were included, including 14 cross-sectional studies and 3 case-control studies. The total sample size was 10,647 cases. The results showed that the influencing factors of postpartum depression in primiparas were social support [OR = 1.43, 95%CI (1.01, 2.01)], educational level [OR = 2.38, 95%CI (1.91, 2.96)], age [OR = 2.2, 95%CI (1.42, 4.88)], mode of delivery [OR = 3.11, 95%CI (1.92, 5.04)], family relationship [OR = 1.56, 95%CI (1.07, 2.28)], neonatal gender [OR = 2.89, 95%CI (1.57, 5.31)], neonatal weight [OR = 2.44, 95%CI (1.63, 3.67)], and unplanned pregnancy [OR = 4.18, 95%CI (1.48, 11.80)]. The sensitivity analysis results indicated that sleep quality [OR = 1.98, 95%CI (1.41, 2.79)], mode of delivery [OR = 4.27, 95%CI (3.09, 5.91)], family relationship [OR = 1.41, 95%CI (1.23, 1.60)], neonatal gender [OR = 3.25, 95%CI (1.51, 6.98)], antenatal anxiety [OR = 2.10, 95%CI (1.55, 2.85)], and unplanned pregnancy [OR = 6.95, 95%CI (3.85, 12.54)] were the influencing factors of postpartum depression in primiparas (all P < 0.01). Conclusion: Social support, educational level, age, mode of delivery, family relationship, neonatal gender, neonatal weight, unplanned pregnancy, sleep quality, and antenatal anxiety are the influencing factors of postpartum depression in primiparas. Special attention should be paid to these factors in clinical work.