Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
Department of Neuropsychiatry, Faculty of Medicine, University of Toyama, Toyama, Japan.
Acta Psychiatr Scand. 2022 Mar;145(3):268-277. doi: 10.1111/acps.13393. Epub 2022 Jan 23.
Women with postpartum depressive symptoms (PDS) are at higher risk of postpartum depression (PPD) and require further assessment. Emerging evidence indicates a relationship between the total cholesterol (TC) level of blood and PPD but the results are inconsistent. In this study, we investigated the possible association of change in serum TC levels during pregnancy with the risk of PDS in a Japanese population.
We analyzed complete data on questionnaire responses and serum lipid profiles of pregnant women from 12 datasets obtained from the Japan Environment and Children's Study (n = 61,585 to n = 72,406; 103,063 pregnancies in total). TC was measured at 3 time points-during early pregnancy, during mid-late pregnancy, and after delivery-and we calculated changes in TC in 3 ways: by subtracting early pregnancy from mid-late pregnancy, subtracting mid-late pregnancy from delivery, and subtracting early pregnancy from delivery. These 6 factors were used as predictors to estimate the risk of PDS at 1 and 6 months after delivery.
In multivariable logistic regression analysis, point serum cholesterol level did not predict PDS at any time point except for during mid-late pregnancy in the second quintile, indicating an increased risk at 6 months. As for change in TC levels, subtracting mid-late pregnancy from delivery and early pregnancy from delivery showed significant risk reduction for PDS at 1 month. A significant risk reduction was also found for subtracting early pregnancy from mid-late pregnancy and early pregnancy from delivery at 6 months.
Increased cholesterol level during pregnancy is associated with reduced risk of PDS.
患有产后抑郁症状（PDS）的女性患产后抑郁症（PPD）的风险更高，需要进一步评估。新出现的证据表明血液总胆固醇（TC）水平与 PPD 之间存在关系，但结果不一致。在这项研究中，我们调查了妊娠期间血清 TC 水平变化与日本人群 PDS 风险之间的可能关联。
我们分析了来自日本环境与儿童研究（n=61585 至 n=72406；总共 103063 例妊娠）的 12 个数据集的问卷调查和血清脂质谱的完整数据。TC 在 3 个时间点进行测量——早孕期、中晚期妊娠和分娩后，并以 3 种方式计算 TC 的变化：从中晚期妊娠减去早孕期，从分娩中减去中晚期妊娠，以及从分娩中减去早孕期。这 6 个因素被用作预测指标，以估计分娩后 1 个月和 6 个月时 PDS 的风险。
在多变量逻辑回归分析中，除了中晚期妊娠的第二个五分位数外，点血清胆固醇水平在任何时间点均不能预测 PDS，这表明 6 个月时风险增加。至于 TC 水平的变化，从中晚期妊娠减去分娩和从早孕期减去分娩显示出 PDS 在 1 个月时有显著的风险降低。从中晚期妊娠减去早孕期和从早孕期减去分娩也发现了显著的风险降低，这发生在 6 个月时。
妊娠期间胆固醇水平升高与 PDS 风险降低相关。
