中国人群产后抑郁状态与纯母乳喂养关联的Meta分析  

A Meta-analysis of the association between postpartum depression and exclusive breastfeeding in the Chinese population

作　　者：李璇[1] Obore Nathan 陶昱辰 胡燕[2] 王一枭 洪翔 王蓓[3] 于红[2] LI Xuan;Obore Nathan;TAO Yuchen;HU Yan;WANG Yixiao;HONG Xiang;WANG Bei;YU Hong(Department of Clinical Medicine,Southeast University School of Medicine,Nanjing 210009,China;Department of Obstetrics and Gynecology,Southeast University Affiliated Zhongda Hospital,Nanjing 210009,China;Department of Epidemiology and Biostatistics,School of Public Health,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学医学院临床医学系,南京210009 [2]东南大学附属中大医院妇产科,南京210009 [3]东南大学公共卫生学院流行病与卫生统计学系,南京210009

出　　处：《中华疾病控制杂志》2023年第11期1329-1335,共7页Chinese Journal of Disease Control & Prevention

基　　金：江苏省卫生健康委员会医学科研项目(2021年第47号)。

摘　　要：目的探究中国人群产后抑郁状态与纯母乳喂养的关联强度。方法检索万方、SinoMed、知网等数据库,查找中国人群产后抑郁状态与纯母乳喂养情况的观察性研究。采用Stata 12.0软件进行Meta分析。并根据地区、产后时间、分组依据及纳入人群进行亚组分析。结果共纳入16篇观察性研究。总体分析抑郁状态组较对照组纯母乳喂养比例低,差异有统计学意义(OR=0.44,95%CI:0.36~0.54,P<0.001)。亚组分析提示处于产后抑郁状态的女性纯母乳喂养比例在东部地区显著降低(OR=0.45,95%CI:0.36~0.56,P<0.001),在中西部地区也降低(OR=0.41,95%CI:0.25~0.66,P<0.001);产后42 d内处于产后抑郁状态的产妇中纯母乳喂养比例降低(OR=0.48,95%CI:0.37~0.61,P<0.001),在产后42 d~6月降低更为显著(OR=0.35,95%CI:0.21~0.60,P<0.001);去除不同分组依据及纳入人群的研究,剩余研究结果与总体结果差异不大,差异均有统计学意义(OR=0.45,95%CI:0.36~0.56,P<0.001)。Meta回归分析提示研究间的异质性地区(P=0.906)、产后时间(P=0.528)、分组依据及纳入人群(P=0.722)差异无统计学意义。结论与对照组相比较,产后抑郁状态人群中纯母乳喂养的比例低。为提高中国人群6个月内纯母乳喂养率、降低产后抑郁患病率,建议从产前开始进行孕产期抑郁筛查及多学科协作干预。Objective To explore the relationship between postpartum depression and exclusive breastfeeding(EBF)in the Chinese population.Methods Observational studies about postpartum depression and feeding patterns were searched in databases including Wanfang,SinoMed,CNKI,and so on.Stata 12.0 was used for meta-analysis.Subgroup analysis for both the control and depression populations was performed according to region,postpartum time,and the groups and populations.Results A total of 16 observational studies were included.The rate of EBF in the postpartum depression group was lower than that in the control group,and the difference was statistically significant(OR=0.44,95%CI:0.36-0.54,P<0.001).Subgroup analysis showed that the depression group had a lower EBF rate than the control group in eastern China(OR=0.45,95%CI:0.36-0.56,P<0.001),as well as in central and western China(OR=0.41,95%CI:0.25-0.66,P<0.001).There was a decreased rate of EBF among mothers that had depression within 42 days postpartum(OR=0.48,95%CI:0.37-0.61,P<0.001)and more significantly between 42 days and 6 months postpartum(OR=0.35,95%CI:0.21-0.60,P<0.001).Exclusion of some studies among the different groups and populations did not significantly alter the overall results and the differences were statistically significant(OR=0.45,95%CI:0.36-0.56,P<0.001).Meta-regression analysis suggested that the source of heterogeneity among studies may not be related to the region(P=0.906),postpartum time(P=0.528),or the groups and populations(P=0.722).Conclusions The rate of EBF is lower in the postpartum depression population compared with the control group.To increase the EBF rate within 6 months and reduce the prevalence of postpartum depression in China,we recommend screening for depression during pregnancy and multidisciplinary collaborative intervention starting from the prenatal period.

关 键 词：抑郁症 产后 母乳喂养 META分析 

分 类 号：R714.7[医药卫生—妇产科学]