目的:围产期自杀未遂(SA)有可能对妇女的健康和发育中的婴儿产生不利影响。迄今为止,对围产期SA及其危险因素知之甚少。本研究旨在综合孕妇和产后妇女SA危险因素的证据。
方法:我们系统回顾了从PubMed/Medline,PsycINFO,和CINAHL,遵循PRISMA报告准则。仅对至少三个不同样本中检查的风险因素进行荟萃分析。
结果:共有10项研究符合纳入条件。所有研究都发现围产期SA与其他变量(社会人口统计学,临床因素产科,新生儿,和社会心理)。荟萃分析显示,未婚女性(合并OR=1.87,95%CI=1.26-2.78),未受过高等教育(合并OR=1.89,95%CI=1.31-2.74)且受情绪障碍影响(合并OR=11.43,95%CI=1.56-83.87)的产后SA风险较高;怀孕期间吸烟的妇女(合并OR=3.87,95%CI=1.35-11.11)在怀孕期间患SA的风险较高;先前有自杀行为的妇女(OR=38.04,43%)无论是在怀孕期间还是在产后期间。样品的类型,无论是社区还是临床,是一个相关的调节因素。
结论:我们的研究通过独立研究围产期自杀企图,扩展了先前关于女性自杀行为的综述,以及它综合了一些社会人口统计学的数据,临床,和产科/新生儿危险因素。需要进一步研究围产期SA的特定危险因素,以改善对有风险妇女的早期发现和干预。
结论:怀孕期间和产后期间的自杀未遂对妇女的健康和婴儿的发育构成严重的风险。尽管它们很重要,对围产期这些尝试的具体危险因素知之甚少.这项研究是第一个综合与孕妇和产后妇女自杀企图相关危险因素的荟萃分析。我们发现未婚女性,那些没有受过高等教育的人,那些有情绪障碍的人产后自杀未遂的风险较高;怀孕期间吸烟的妇女在怀孕期间自杀未遂的风险较高;那些先前有自杀行为的人围产期自杀未遂的风险较高。我们的研究通过独立检查围产期自杀企图并综合社会人口统计学数据来扩展先前的评论,临床,和产科/新生儿危险因素。需要进一步研究围产期自杀未遂的特定危险因素,以改善对有风险妇女的早期发现和干预。
OBJECTIVE: Suicide attempts (SA) during perinatal period have the potential to adversely affect a woman\'s health and her developing infant. To date, little is known about perinatal SA and their risk factors. This study aimed to synthetize the evidence on risk factors of SA in pregnant and postpartum women.
METHODS: We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, and CINAHL, following the PRISMA guidelines for reporting. A meta-analysis was conducted only for risk factors examined in at least three distinct samples.
RESULTS: A total of ten studies were eligible for inclusion. All the studies found significant associations in regression models between perinatal SA and other variables (sociodemographic, clinical factors obstetric, neonatal, and psychosocial). The meta-analysis showed that unmarried women (pooled OR = 1.87, 95% CI = 1.26-2.78), with no higher education (pooled OR = 1.89, 95% CI = 1.31-2.74) and affected by a mood disorder (pooled OR = 11.43, 95% CI = 1.56-83.87) have a higher risk of postpartum SA; women who smoke during pregnancy (pooled OR = 3.87, 95% CI = 1.35-11.11) have a higher risk of SA in pregnancy; and women with previous suicidal behavior(pooled OR = 38.04, 95% CI = 3.36-431.17) have a higher risk of perinatal SA, whether during pregnancy or in the postpartum period. The type of sample, whether community or clinical, is a relevant moderating factor.
CONCLUSIONS: Our study extends prior reviews about suicidal behaviors in women by studying perinatal suicide attempts independently, as well as it synthesized data on some sociodemographic, clinical, and obstetric/neonatal risk factors. Further studies about specific risk factors for perinatal SA are needed in order to improve early detection and intervention of women at risk.
CONCLUSIONS: Suicide attempts during pregnancy and the postpartum period pose a severe risk to the health of women and the development of their infants. Despite their importance, little is known about specific risk factors for these attempts during the perinatal period. This study is the first meta-analysis to synthesize risk factors associated with suicide attempts in pregnant and postpartum women. We found that unmarried women, those without higher education, and those with mood disorders are at higher risk for postpartum suicide attempts; women who smoke during pregnancy are at higher risk for suicide attempts during pregnancy; and those with previous suicidal behavior are at higher risk for perinatal suicide attempts. Our study extends prior reviews by independently examining perinatal suicide attempts and synthesizing data on sociodemographic, clinical, and obstetric/neonatal risk factors. Further studies on specific risk factors for perinatal suicide attempts are needed to improve early detection and intervention for women at risk.