Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul, South Korea.
J Affect Disord. 2022 Nov 1;316:56-62. doi: 10.1016/j.jad.2022.07.065. Epub 2022 Aug 5.
Prior literature examining the association between cigarette smoking and postpartum depression (PPD) has focused primarily on smoking behaviors during pregnancy or postpartum. However, there is a dearth of studies assessing pre-pregnancy smoking in relation to PPD.
A retrospective national cohort data from the National Health Insurance of South Korea were analyzed. A total of 392,394 women who gave birth between 2011 and 2015 and received health checkups within a year before pregnancy without a history of diagnosed depression were included. During the health checkup, participants self-reported their smoking status, amount, and duration in a health questionnaire. The diagnosis of PPD was defined by ICD-10 codes F32 and F33 during hospital visits within two years postpartum.
Overall, 24,441 (6.2 %) women were newly diagnosed with depression within two years postpartum. Those who reported that they had quit smoking or were currently smoking before pregnancy were more likely to be diagnosed with PPD compared to nonsmokers. A greater number of cigarettes smoked was associated with a higher risk of PPD for both current and former smokers. Results of cumulative lifetime smoking exposure demonstrated that even those with 2 pack-years of smoking had an increased risk of developing PPD within two years postpartum (HR: 1.44, 95 % CI: 1.29-1.60). Those who smoked >10 pack-years had the highest risk of developing PPD (HR: 1.86, 95 % CI: 1.14-3.04) compared to nonsmokers.
Greater amount and duration of cigarette smoking in pre-pregnancy can increase the risk of PPD.
既往研究主要关注怀孕期间或产后的吸烟行为与产后抑郁症（PPD）之间的关联，但评估与 PPD 相关的孕前吸烟情况的研究却很少。
本研究使用了来自韩国国家健康保险的回顾性全国队列数据。共纳入 392394 名 2011 年至 2015 年间分娩且在怀孕前一年内接受过健康检查但无诊断性抑郁病史的女性。在健康检查期间，参与者通过健康问卷自行报告吸烟状况、吸烟量和吸烟持续时间。在产后两年内的就诊中，使用 ICD-10 编码 F32 和 F33 来诊断 PPD。
总体而言，有 24441 名（6.2%）女性在产后两年内被新诊断为抑郁症。与不吸烟者相比，报告在怀孕前已经戒烟或正在吸烟的女性更有可能被诊断为 PPD。当前吸烟者和曾经吸烟者吸烟量越大，患 PPD 的风险越高。累积终生吸烟暴露的结果表明，即使吸烟 2 包年，在产后两年内也会增加患 PPD 的风险（HR：1.44，95%CI：1.29-1.60）。与不吸烟者相比，吸烟>10 包年的人患 PPD 的风险最高（HR：1.86，95%CI：1.14-3.04）。
孕前吸烟量和吸烟时间的增加都可能增加 PPD 的风险。
