维生素D 水平与产后抑郁相关性的Meta 分析
| 作者: |
1韩艳艳,
1李小琳,
1贾萌萌,
1程晓琳,
1杨雪,
1田晓予
1 河南科技大学临床医学院，河南科技大学第一附属医院妇产科， 河南 洛阳 471003 |
| 通讯: |
田晓予
Email: tianxiaoy1210@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.06.023 |
| 基金: | 河南省卫生与计划生育委员会科技攻关项目 (201503140)。 |
摘要
目的：系统评价孕产期血清维生素D水平与产后抑郁症( post par tum depression，PPD)发病风险的相关性。方法：分别在PubMed，PsycINFO，The Cochrane Librar y，Embase，中国知网(China National Knowledge Infrastructure，CNKI)，中国生物医学文献服务系统(China Biolog y Medicine disc，CBM)，万方和维普数据库搜索国内外公开发表的有关孕产期血清维生素D水平与PPD相关性的研究，检索时间均为建库至2018年2月28日。纳入文献由2名评价者严格按照纳入与排除标准独立筛选文献、提取资料及评估纳入研究的偏倚风险后，采用RevMan5.3软件进行分析Meta分析。结果：共纳入3篇病例对照研究和8篇队列研究，共5 052例孕产妇。其中3项研究表明PPD与血清维生素D水平不相关，8项研究表明PPD与血清维生素D水平低于50 nmol/L显著相关。提取数据后有5篇研究的血清维生素D水平分组与PPD评分量表不统一，无法进行数据合并分析，只对其中6篇文献数据转换后进行Meta分析，其中4篇文献提取具体病例数共包括试验组1 571例和对照组1 857例。 Met a分析结果显示：血清维生素D水平截取值在50 nmol/L时与PPD发病无相关性(OR=1.24， 95%CI 0.92~1.69，P=0.16)。另外2篇中血清维生素D截取值在50 nmol/L时与PPD发病无相关性(MD=−0.18，95%CI −1.20~0.84，P=0.74)。再次截取血清维生素D严重缺乏水平25 nmol/L，提取病例数的4篇文献数据Meta分析结果显示：血清维生素D截取值在25 nmol/L时与PPD发病无相关性(OR=2.63，95%CI 1.14~6.09，P=0.02)。结论：孕产妇血清维生素D水平低于50 nmol/L时，尚不能提示与PPD相关。当孕产妇血维生素D水平低于25 nmol/L时，可能为PPD发病的危险因素。
关键词：
产后抑郁；维生素D；Meta分析
Blood vitamin D levels and the risk of postpartum depression: A Meta-analysis
CorrespondingAuthor: TIAN Xiaoyu Email: tianxiaoy1210@163.com
DOI: 10.3978/j.issn.2095-6959.2019.06.023
Foundation: This work was supported by the Scientific and Technical Tackle Problem Project of Health and Family planning Commission of Henan Province, China (201503140).
Abstract
Objective: To systematically evaluate the correlation between vitamin D levels in pregnancy and the risk of postpartum depression (PPD). Methods: The research on the correlation between vitamin D and PPD was searched in PubMed, PsycINFO, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM) Wanfang Data and Wiper Databases, respectively. The retrieval time of the database was built up to February 30, 2018. After the two evaluators independently sifted the literature according to the inclusion and exclusion criteria, extracted the data and evaluated the bias risk of the inclusion study, the meta-analysis was carried out with RevMan5.3 software. Results: Three case-control studies and eight cohort studies were included in this study, and 5 052 pregnant women were included in this study, in which three studies showed that postpartum depression was not associated with vitamin D levels, eight showed that postpartum depression was significantly associated with low vitamin D levels. After extracting the data, there were 5 studies on vitamin D levels and the inconsistency of postpartum depression rating scale. Only 6 of them were analyzed by Meta-analysis. There were 1 571 cases in the trial group and 1 857 cases in the control group. The results of Meta-analysis showed that there was no significant correlation between the value of vitamin D interception and PPD (OR=1.24, 95%CI 0.92–1.69, P=0.16) at the level of 50 nmol/L. The other two studies showed that there was no significant correlation between vitamin D interception value at 50 nmol/L and PPD (MD=−0.18, 95%CI −1.20–0.84, P=0.74) at the level of 50 nmol/L. Meta-analysis showed that vitamin D interception was associated with PPD in 25 nmol/L (OR=2.63, 95%CI 1.14–6.09, P=0.02). Conclusion: When the serum vitamin D level of pregnant women is lower than 50 nmol/L, it could not be associated with PPD. When serum vitamin D level is lower than 25 nmol/L, it is a risk factor for PPD in pregnant women.
Keywords：
postpartum depression; vitamin D; Meta-analysis