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已发表论文
关联之间抑郁症和风险的妊娠剧吐：一项系统综述与荟萃分析
Authors Xu J, Qin Z, Wang X, Chen J, Zhuang L
Received 25 September 2025
Accepted for publication 31 December 2025
Published 5 February 2026 Volume 2026:22 567778
DOI https://doi.org/10.2147/NDT.S567778
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Roger Pinder
Jiao Xu,1,* Ziyi Qin,2,* Xiaoyin Wang,1 Jin Chen,1 Lin Zhuang1
1Department of Obstetrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2College of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lin Zhuang, Department of Obstetrics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39-41, Shierqiao Road, Jinniu District, Chengdu, Sichuan, People’s Republic of China, Tel +86 15608086789, Email 1305@cdutcm.edu.cn
Background: Hyperemesis gravidarum (HG) is a severe pregnancy-related condition that may be influenced by maternal psychological factors. This meta-analysis aimed to evaluate the association between maternal depression and the risk of HG and to explore whether this association varies by maternal or study characteristics.
Methods: A systematic search was conducted in PubMed, Embase, and Web of Science databases up to May 2, 2025, to identify observational studies examining the association between depression, assessed either prior to or during pregnancy, and HG. Heterogeneity was evaluated using the Cochrane Q test and I2 statistic. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model, incorporating the influence of heterogeneity. Subgroup analyses were conducted by maternal age, timing of depression assessment, diagnostic tools, timing of HG diagnosis, adjustment for gravidity or parity, and study quality.
Results: Totally, 13 case-control studies involving 95,249 pregnant women were included. Maternal depression was associated with a significantly higher risk of HG (OR: 5.08, 95% CI: 2.71– 9.52; p < 0.001; I2 = 93%). The association was stronger among women who were younger than 27 years (OR: 11.64) than in those who aged 27 years or older (OR: 2.86; p (for subgroup difference) = 0.02). Depression assessed at the time of HG diagnosis showed a stronger association (OR: 6.04) than when assessed before diagnosis (OR: 2.11; p (for subgroup difference) = 0.04). Studies using the Beck Depression Inventory or Edinburgh Postnatal Depression Scale reported stronger associations than those using the Hospital Anxiety and Depression Scale (p (for subgroup difference) = 0.009).
Conclusion: Maternal depression is associated with the occurrence of HG; however, this association does not imply causation, and depressive symptoms may reflect the psychological impact of this severe condition.
Keywords: hyperemesis gravidarum, pregnancy, depression, risk factor, meta-analysis
1Department of Obstetrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2College of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lin Zhuang, Department of Obstetrics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39-41, Shierqiao Road, Jinniu District, Chengdu, Sichuan, People’s Republic of China, Tel +86 15608086789, Email 1305@cdutcm.edu.cn
Background: Hyperemesis gravidarum (HG) is a severe pregnancy-related condition that may be influenced by maternal psychological factors. This meta-analysis aimed to evaluate the association between maternal depression and the risk of HG and to explore whether this association varies by maternal or study characteristics.
Methods: A systematic search was conducted in PubMed, Embase, and Web of Science databases up to May 2, 2025, to identify observational studies examining the association between depression, assessed either prior to or during pregnancy, and HG. Heterogeneity was evaluated using the Cochrane Q test and I2 statistic. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model, incorporating the influence of heterogeneity. Subgroup analyses were conducted by maternal age, timing of depression assessment, diagnostic tools, timing of HG diagnosis, adjustment for gravidity or parity, and study quality.
Results: Totally, 13 case-control studies involving 95,249 pregnant women were included. Maternal depression was associated with a significantly higher risk of HG (OR: 5.08, 95% CI: 2.71– 9.52; p < 0.001; I2 = 93%). The association was stronger among women who were younger than 27 years (OR: 11.64) than in those who aged 27 years or older (OR: 2.86; p (for subgroup difference) = 0.02). Depression assessed at the time of HG diagnosis showed a stronger association (OR: 6.04) than when assessed before diagnosis (OR: 2.11; p (for subgroup difference) = 0.04). Studies using the Beck Depression Inventory or Edinburgh Postnatal Depression Scale reported stronger associations than those using the Hospital Anxiety and Depression Scale (p (for subgroup difference) = 0.009).
Conclusion: Maternal depression is associated with the occurrence of HG; however, this association does not imply causation, and depressive symptoms may reflect the psychological impact of this severe condition.
Keywords: hyperemesis gravidarum, pregnancy, depression, risk factor, meta-analysis