心理干预对反复种植失败患者负性情绪与妊娠结局影响的Meta分析  

A Meta-analysis of the effects of psychological intervention on negative emotions and pregnancy outcomes in patients with recurrent implantation failure

作　　者：韩委彤 杨新燕 杨娟 Han Weitong;Yang Xinyan;Yang Juan(School of Public Health,Hainan Medical University;Department of Mental Health Promotion,Affiliated Maternal and Child Health Care Center/Affiliated Children's Hospital,Hainan Medical University,Haikou Hainan 570100,P.R.China)

机构地区：[1]海南医科大学公共卫生学院,海南海口570100 [2]海南医科大学附属妇幼保健院/附属儿童医院心理健康促进科

出　　处：《中国计划生育和妇产科》2025年第3期46-51,57,共7页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的系统评价心理干预对反复种植失败(RIF)患者负性情绪及妊娠结局的影响。方法计算机检索PubMed、Web of Science、中国知网(CNKI)等数据库,检索时限从建库至2024年3月,搜集关于心理干预对RIF患者妊娠结局影响的相关随机对照试验(RCT)。结局指标包括SAS评分、SDS评分、受精率、优胚率、临床妊娠率、自然流产率。应用RevMan 5.4.1软件进行Meta分析。结果最终共纳入16项随机对照试验,包括2025例研究对象(试验组1013例,对照组1012例)。Meta分析结果显示,与对照组相比,心理干预可以明显降低SAS评分[MD=-6.74,95%CI(-8.92,-4.55),P<0.00001]和SDS评分[MD=-6.62,95%CI(-8.20,-5.03),P<0.00001];并能显著提高受精率[RR=1.09,95%CI(1.02,1.17),P=0.01]及临床妊娠率[RR=1.72,95%CI(1.53,1.93),P<0.00001],降低自然流产率[RR=0.33,95%CI(0.11,0.96),P=0.04]。结论心理干预能明显改善RIF患者的焦虑、抑郁情绪,并能有效提高受精率、临床妊娠率及降低自然流产率,但仍需开展结局指标更为全面的高质量RCT研究来进一步验证。Objective To systematically review the effects of psychological intervention on negative emotions and pregnancy outcome of patients with recurrent implantation failure.Methods Randomized controlled trials(RCTs)on the effects of psychological intervention on pregnancy outcomes in RIF patients were searched in PubMed,Web of Science,CNKI and other databases from establishment to March 2024.The outcome indexes included SAS score,SDS score,fertilization rate,high-quality embryo rate,clinical pregnancy rate and spontaneous abortion rate.Meta-analysis was performed using RevMan 5.4.1 software.Results A total of 16 randomized controlled trials were included,including 2025 subjects(1013 in the experimental group and 1012 in the control group).The results of Meta-analysis showed that compared with the control group,psychological intervention could significantly reduce SAS score[MD=-6.74,95%CI(-8.92,-4.55),P<0.00001]and SDS score[MD=-6.62,95%CI(-8.20,-5.03),P<0.00001].It also significantly increased the fertilization rate[RR=1.09,95%CI(1.02,1.17),P=0.01]and clinical pregnancy rate[RR=1.72,95%CI(1.53,1.93),P<0.00001],and decreased the spontaneous abortion rate[RR=0.33,95%CI(0.11,0.96),P=0.04].Conclusion Psychological intervention can significantly improve the anxiety and depression of RIF patients,and can effectively improve the fertilization rate,clinical pregnancy rate and reduce the spontaneous abortion rate,but it is still necessary to conduct high-quality RCT studies with more comprehensive outcome indicators for further verification.

关 键 词：心理干预 反复种植失败 负性情绪 妊娠结局 META分析 

分 类 号：R714.8[医药卫生—妇产科学]