Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
Acta Obstet Gynecol Scand. 2018 Jul;97(7):838-844. doi: 10.1111/aogs.13332. Epub 2018 Mar 13.
Women with polycystic ovary syndrome are susceptible to depression and anxiety and so may also be at risk for postnatal depression. This study investigates whether women with polycystic ovary syndrome have an elevated risk of postnatal depression.
Cross-sectional data for parous women (n = 566) were available from a birth cohort. Polycystic ovary syndrome was diagnosed using the Rotterdam criteria. Details of reproductive history, pregnancy, birth, and postnatal depression were obtained through structured interview. Comparisons were made between women with and without polycystic ovary syndrome using logistic regression analysis, including the investigation of interactions.
A positive but statistically non-significant association was found between polycystic ovary syndrome and postnatal depression (odds ratio 1.6, 95% confidence interval 0.9-2.9). Compared with their counterparts, women with polycystic ovary syndrome were substantially more likely: to have difficulty conceiving (odds ratio 5.2, 95% confidence interval 2.9-9.4), to have conceived with medical assistance (odds ratio 11.6, 95% confidence interval 5.5-24.4), and to have pregnancy complications (gestational diabetes, pregnancy-induced hypertension, or preeclampsia; odds ratio 2.0, 95% confidence interval 1.1-3.5). Where women with polycystic ovary syndrome had a history of miscarriage or conceived with medical assistance, the combination interacted (p = 0.06 and p < 0.05, respectively), with over half of such women having postnatal depression.
Although women with polycystic ovary syndrome may not have an excess risk of postnatal depression overall, those who had suffered a miscarriage or required medical assistance to conceive were at substantially elevated risk. Findings point to vulnerability inherent in polycystic ovary syndrome being amplified, either by stressful experiences on the pathway to pregnancy/childbirth or by specific fertility treatment regimens.
多囊卵巢综合征患者易患抑郁症和焦虑症，因此也可能面临产后抑郁症的风险。本研究旨在探讨多囊卵巢综合征患者是否存在产后抑郁症发病风险升高的问题。
来自出生队列的经产妇女（n=566）的横断面数据可用于本研究。多囊卵巢综合征采用 Rotterdam 标准进行诊断。通过结构化访谈获得生育史、妊娠、分娩和产后抑郁症的详细信息。采用逻辑回归分析比较多囊卵巢综合征患者与非多囊卵巢综合征患者，包括交互作用的调查。
多囊卵巢综合征与产后抑郁症之间存在正相关，但统计学上无显著性（比值比 1.6，95%置信区间 0.9-2.9）。与对照组相比，多囊卵巢综合征患者更有可能：受孕困难（比值比 5.2，95%置信区间 2.9-9.4）、需要医疗辅助受孕（比值比 11.6，95%置信区间 5.5-24.4）和妊娠并发症（妊娠期糖尿病、妊娠高血压或先兆子痫；比值比 2.0，95%置信区间 1.1-3.5）。对于有多囊卵巢综合征病史或需要医疗辅助受孕的患者，这些因素存在交互作用（p=0.06 和 p<0.05），其中超过一半的患者患有产后抑郁症。
尽管总体而言，多囊卵巢综合征患者产后抑郁症的风险可能没有增加，但曾经历过流产或需要医疗辅助受孕的患者风险显著升高。这些发现表明多囊卵巢综合征的固有脆弱性可能会因妊娠/分娩过程中的应激经历或特定的生育治疗方案而放大。
