■剖宫产(CS)与产后抑郁症(PPD)的关联仍存在争议。本研究旨在探讨CS与PPD风险的关系,为预防PPD提供依据。
■我们搜索了PubMed,WebofScience,科克伦图书馆,以及截至2024年2月发表的关于CS和PPD之间相关性的文献EMBASE数据库。通过灵活使用固定效应模型或随机效应模型获得组合优势比(OR)和95%置信区间(Cls)。
■总共18种出版物最终包括在分析中。其中,14个是队列研究,4个是病例对照报告,涵盖844,328宗案件。所有纳入的研究都被认为是中等或更高质量的。Meta分析显示,CS患者PPD的患病率为13.4%(95%CI:6.5%~25.5%)。与自然阴道分娩(NVD)组相比,CS和PPD之间关联的校正比值比(OR)为1.12(95%CI:1.04-1.20)。具体来说,在产后前1-6个月,CS和PPD之间的校正OR为1.29(95%CI:1.18-1.40),产后6个月后为1.23(95%CI:1.14-1.33)。此外,与NVD组相比,择期剖腹产(ELCS)和急诊剖腹产(EMCS)的校正OR分别为0.96(0.83,1.10)和1.20(1.08,1.34),分别。
■我们的研究结果表明,在CS的存在下,PPD风险可能会上升。特别是,EMCS组的风险增加了20%,与产后6个月相比,CS后产后1至6个月内发生PPD的风险增加了6%。在未来,需要更合理的设计和深入研究来获得更准确的信息。
■https://www.crd.约克。AC.uk/PROSPERO/#recordDetails,标识符CRD42023389265。
UNASSIGNED: The association of caesarean section (CS) for postpartum depression (PPD) remains controversial. This study aims to explore the relationship between CS and the risk of PPD, in order to provide a basis for preventing PPD.
UNASSIGNED: We searched PubMed, Web of Science, Cochrane Library, and EMBASE databases for literature about the correlation between CS and PPD published as of February 2024. The combined odds ratios (ORs) and 95% confidence intervals (Cls) were obtained by flexible use of fixed-effects models or random-effects models.
UNASSIGNED: A total of 18 publications were ultimately included in the analysis. Among these, 14 were cohort studies and 4 were case-control reports, encompassing 844,328 total cases. All of the included studies were deemed to be of moderate or higher quality. The meta-analysis indicated that the prevalence of PPD among parturients undergoing CS was 13.4% (95% CI: 6.5%-25.5%).The adjusted odds ratio (OR) for the association between CS and PPD was 1.12 (95% CI: 1.04-1.20) compared to the natural vaginal delivery (NVD) group. Specifically, the adjusted OR for the association between CS and PPD was 1.29 (95% CI: 1.18-1.40) during the first 1-6 months postpartum, and 1.23 (95% CI: 1.14-1.33) after 6 months postpartum. Furthermore, in comparison to the NVD group, the adjusted OR for elective caesarean section (ELCS) and emergency caesarean section (EMCS) were 0.96 (0.83, 1.10) and 1.20 (1.08, 1.34), respectively.
UNASSIGNED: Our findings suggest that PPD risk may rise in the presence of CS. In particular, the risk was increased by 20% in the EMCS group, and the risk of PPD within one to six months postpartum after CS increases by 6% compared to that at six months postpartum. In the future, more rational designs and in-depth studies are needed to obtain more accurate information.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42023389265.