Civic D, Scholes D, Ichikawa L, LaCroix A Z, Yoshida C K, Ott S M, Barlow W E
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington 98101, USA.
Contraception. 2000 Jun;61(6):385-90. doi: 10.1016/s0010-7824(00)00122-0.
To evaluate the possible effects of depot medroxyprogesterone acetate (DMPA) injectable contraception on depressive symptoms, we conducted a population-based prospective study with women aged 18-39 years old enrolled at a health maintenance organization. At baseline, 183 women used DMPA and 274 were non-users. Data on depressive symptoms and on factors potentially related to DMPA use and depression were collected by questionnaire at 6-month intervals for up to 3 years. In multivariate longitudinal analysis, we found an increased likelihood of reporting depressive symptoms among continuous DMPA users (OR = 1.44; 95% CI = 1.00-2.07) and discontinuers (OR = 1.60; 95% CI = 1.03-2.48) when compared to non-users. Women who discontinued DMPA use had elevated depressive symptoms prior to discontinuation (OR = 2.30; 95% CI = 1.42-3.70) and immediately following discontinuation (OR = 2.46; 95% CI = 1. 46-4.14), and depressive symptoms subsided at subsequent visits relative to non-users. Our prospective analyses found an association between DMPA use and depressive symptoms but further research is needed to determine whether the relationship is causal.
为评估醋酸甲羟孕酮长效注射剂（DMPA）避孕对抑郁症状的可能影响，我们在一家健康维护组织中对18至39岁的女性进行了一项基于人群的前瞻性研究。基线时，183名女性使用DMPA，274名女性未使用。通过问卷调查，每6个月收集一次抑郁症状以及与DMPA使用和抑郁可能相关因素的数据，为期长达3年。在多变量纵向分析中，我们发现与未使用者相比，持续使用DMPA的人群（比值比[OR]=1.44；95%置信区间[CI]=1.00 - 2.07）和停用者（OR = 1.60；95% CI = 1.03 - 2.48）报告抑郁症状的可能性增加。停用DMPA的女性在停用前（OR = 2.30；95% CI = 1.42 - 3.70）和停用后立即出现抑郁症状升高（OR = 2.46；95% CI = 1.46 - 4.14），且相对于未使用者，在后续访视中抑郁症状有所缓解。我们的前瞻性分析发现DMPA使用与抑郁症状之间存在关联，但需要进一步研究以确定这种关系是否为因果关系。
