Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Tongxiang Center for Disease Control and Prevention, Jiaxing, Zhejiang, China.
J Affect Disord. 2019 Mar 1;246:174-181. doi: 10.1016/j.jad.2018.12.031. Epub 2018 Dec 18.
Although there are potential mechanisms of female hormones in depression, conflicting results still exist in epidemiological studies. This study aimed to determine whether reproductive history, an important indicator of estrogen exposure across the lifetime, is associated with risk of depressive symptoms in postmenopausal women.
We analyzed the baseline data from Zhejiang Ageing and Health Cohort Study including 5537 postmenopausal women. Depressive symptoms were assessed through the application of Patient Health Questionnaire-9 scale (PHQ-9). Logistic regression models, controlling for an extensive range of potential confounders, were generated to examine the association between reproductive history and risk of depressive symptoms in later life.
Longer reproductive period (Odds Ratio (OR) = 0.972, 95% Confidence Interval (CI) 0.955-0.989), regular menstrual cycle (OR = 0.723, 95% CI 0.525-0.995), later age at first gave birth (OR = 0.953, 95% CI 0.919-0.988) were significantly associated with a reduced risk of late-life depressive symptoms. Among women with regular menstrual cycle, longer cycle length increased the risk (OR = 1.050, 95% CI 1.016-1.085). Meanwhile, more full-term pregnancies and more incomplete pregnancies were related to higher prevalence of depressive symptoms. Women who underwent tubal sterilization as only type of contraceptive surgery were found less likely to suffer depressive symptoms in later life (OR = 0.433, 95% CI 0.348-0.538).
Cross-sectional data could not make a causation conclusion.
Our results indicated that reproductive factors were significantly associated with risk of depressive symptoms in postmenopausal women. Further longitudinal studies are needed.
尽管女性激素在抑郁症中有潜在的作用机制，但流行病学研究的结果仍存在冲突。本研究旨在确定生殖史（一生中雌激素暴露的重要指标）是否与绝经后妇女患抑郁症状的风险相关。
我们分析了包括 5537 名绝经后妇女在内的浙江老龄化与健康队列研究的基线数据。使用患者健康问卷-9 量表（PHQ-9）评估抑郁症状。通过生成包含广泛潜在混杂因素的逻辑回归模型，来检验生殖史与晚年抑郁症状风险之间的关联。
较长的生育期（比值比（OR）=0.972，95%置信区间（CI）0.955-0.989）、规律的月经周期（OR=0.723，95%CI 0.525-0.995）、初次分娩年龄较晚（OR=0.953，95%CI 0.919-0.988）与降低晚年抑郁症状的风险显著相关。在有规律月经周期的女性中，较长的周期长度会增加风险（OR=1.050，95%CI 1.016-1.085）。同时，更多的足月妊娠和更多的不完全妊娠与更高的抑郁症状发生率相关。仅行输卵管绝育术作为避孕手术的女性在晚年更不易患抑郁症状（OR=0.433，95%CI 0.348-0.538）。
横断面数据不能得出因果关系的结论。
我们的研究结果表明，生殖因素与绝经后妇女患抑郁症状的风险显著相关。需要进一步进行纵向研究。
