Department of Psychiatry,Erasmus Medical Centre,Rotterdam,The Netherlands.
Department of Medical and Clinical Psychology,Tilburg University,Tilburg,The Netherlands.
Psychol Med. 2018 Jun;48(8):1291-1298. doi: 10.1017/S0033291717002732. Epub 2017 Sep 20.
The postpartum period is well-known risk period for the first onset of autoimmune thyroid disorders (AITDs) as well as first onset of psychiatric disorders. These two disorders are some of the most prevalent medical conditions postpartum, often misdiagnosed and disabling if left untreated. Our study was designed to explore the possible bidirectional association between AITDs and psychiatric disorders during the postpartum period.
A population-based cohort study through linkage of Danish national registers, which comprised 312 779 women who gave birth to their first child during 1997-2010. We conducted Poisson regression analysis to estimate the incidence rate ratio (IRR) of psychiatric disorders among women with first-onset AITDs, the IRR of AITDs among women with first-onset psychiatric disorders as well as the overlap between these disorders using a comorbidity index.
Women with first-onset AITDs postpartum were more likely to have first-onset psychiatric disorders than women who did not have postpartum AITDs (IRR = 1.88, 95% confidence interval (CI): 1.25-2.81). Women with first-onset postpartum psychiatric disorders had a higher risk of AITDs than women with no psychiatric disorders (IRR = 2.16, 95% CI: 1.45-3.20). The comorbidity index 2 years after delivery was 2.26 (95% CI: 1.61-2.90), indicating a comorbidity between first-onset AITDs and psychiatric disorders.
First-onset AITDs and psychiatric disorders co-occur in the postpartum period, which has relevance to further studies on the etiologies of these disorders and why childbirth in particular triggers the onset.
产后阶段是自身免疫性甲状腺疾病（AITD）和精神障碍首次发病的高危时期。这两种疾病是产后最常见的疾病之一，如果不加以治疗，往往会被误诊并导致残疾。我们的研究旨在探讨 AITD 和产后精神障碍之间可能存在的双向关联。
这是一项基于人群的队列研究，通过丹麦国家登记处进行链接，共纳入 1997 年至 2010 年间首次分娩的 312779 名女性。我们采用泊松回归分析估计首次发生 AITD 的女性发生精神障碍的发病率比（IRR）、首次发生精神障碍的女性发生 AITD 的 IRR 以及使用共病指数评估这些疾病之间的重叠。
产后首次发生 AITD 的女性比未发生产后 AITD 的女性更有可能首次发生精神障碍（IRR=1.88，95%置信区间[CI]：1.25-2.81）。首次发生产后精神障碍的女性发生 AITD 的风险高于无精神障碍的女性（IRR=2.16，95%CI：1.45-3.20）。产后 2 年的共病指数为 2.26（95%CI：1.61-2.90），表明首次发生 AITD 和精神障碍之间存在共病。
产后首次发生 AITD 和精神障碍同时存在，这与进一步研究这些疾病的病因以及为什么分娩会特别引发这些疾病有关。
