University of Montreal Hospital Research Centre, Montreal, QC, Canada.
Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, QC, H2P 1E2, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2021 Mar;56(3):429-436. doi: 10.1007/s00127-020-01920-x. Epub 2020 Jul 11.
The association between pregnancy characteristics and risk of depression in women is poorly understood. We investigated the relationship between preeclampsia and risk of hospitalization for depression over three decades.
We carried out a longitudinal cohort study of 1,210,963 women who delivered an infant in any hospital in Quebec, Canada, between 1989 and 2016. The exposure was preeclampsia at the first or in subsequent pregnancies, including preeclampsia onset time (early < 34 weeks vs. late ≥ 34 weeks of gestation) and severity (mild, severe, superimposed). The outcome was hospitalization for depression any time after pregnancy. We used Cox proportional hazards regression models adjusted for maternal characteristics to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of preeclampsia with depression hospitalization.
Women with preeclampsia had a higher incidence of hospitalization for depression compared with no preeclampsia (1.43 vs. 1.14 per 1000 person-years). Preeclampsia was associated with 1.16 times the risk of depression hospitalization after 28 years of follow-up (95% CI 1.09-1.23). Associations were present for mild (HR 1.15, 95% CI 1.07-1.24), severe (HR 1.16, 95% CI 1.04-1.29) and late onset preeclampsia (HR 1.17, 95% CI 1.10-1.25). Risks were more pronounced after the first year postpartum.
Preeclampsia appears to be associated with the risk of depression hospitalization several decades after pregnancy. Clinicians who care for women with mental health disorders should be aware that a history of preeclampsia increases the risk of severe depression.
妊娠特征与女性抑郁风险之间的关联尚未被充分理解。我们调查了三十年来子痫前期与抑郁住院风险之间的关系。
我们对 1989 年至 2016 年期间在加拿大魁北克省任何一家医院分娩的 1210963 名女性进行了一项纵向队列研究。暴露因素为首次或后续妊娠中的子痫前期，包括子痫前期发病时间（早于 34 周<或晚于 34 周）和严重程度（轻度、重度、重叠性）。结局为妊娠后任何时间因抑郁住院。我们使用 Cox 比例风险回归模型，根据产妇特征进行调整，以估计子痫前期与抑郁住院相关的风险比（HR）和 95%置信区间（CI）。
与无子痫前期的女性相比，患有子痫前期的女性抑郁住院的发生率更高（每 1000 人年 1.43 比 1.14）。在 28 年的随访后，子痫前期与抑郁住院风险增加 1.16 倍相关（95%CI 1.09-1.23）。轻度子痫前期（HR 1.15，95%CI 1.07-1.24）、重度子痫前期（HR 1.16，95%CI 1.04-1.29）和晚发型子痫前期（HR 1.17，95%CI 1.10-1.25）均存在关联。产后第一年过后，风险更为显著。
子痫前期似乎与妊娠后几十年的抑郁住院风险相关。照顾有心理健康障碍的女性的临床医生应该意识到，子痫前期病史会增加重度抑郁症的风险。
