Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, South Korea.
Gen Hosp Psychiatry. 2023 Jul-Aug;83:35-42. doi: 10.1016/j.genhosppsych.2023.04.001. Epub 2023 Apr 6.
To examine the association between female reproductive factors and the risk of depression.
A retrospective cohort study was performed using a national database in South Korea. Among 945,729 eligible postmenopausal women, the associations between female reproductive factors including the age at menarche, age at menopause, parity, duration of oral contraceptive (OC) use, duration of breastfeeding, and use of menopausal hormone therapy (MHT), and the occurrence of depression were investigated.
Compared to women with menarche at the age of ≤12 years, those with menarche at the age of ≥15 showed an increased risk of depression [adjusted hazard ratio (aHR) of 1.09 for 15-16 years and 1.18 for ≥17 years]. Compared to women with menopause at the age of 50-54, those with menopause at an earlier age showed an increased risk of depression (aHR of 1.20 for <40 years), and those with menopause at a later age showed a decreased risk of depression (aHR of 0.94 for ≥55 years). Use of MHT was associated with an increased risk of depression (aHR of 1.30 for ≥5 years). Duration of breastfeeding and duration of OC use had U-shaped but weak associations with depression. Whereas parity did not show a significant association with depression.
Late menarche, early menopause, and the use of MHT were associated with an increased risk of depression in postmenopausal women.
探讨女性生殖因素与抑郁风险的关系。
本研究采用韩国国家数据库进行了一项回顾性队列研究。在 945729 名符合条件的绝经后女性中，调查了女性生殖因素（包括初潮年龄、绝经年龄、产次、口服避孕药（OC）使用时间、母乳喂养时间和绝经激素治疗（MHT）使用情况）与抑郁发生的相关性。
与 12 岁及以下初潮的女性相比，15 岁及以上初潮的女性发生抑郁的风险增加（15-16 岁的校正风险比[aHR]为 1.09，17 岁及以上的 aHR 为 1.18）。与 50-54 岁绝经的女性相比，更早绝经（<40 岁的 aHR 为 1.20）与抑郁风险增加相关，而更晚绝经（≥55 岁的 aHR 为 0.94）与抑郁风险降低相关。MHT 的使用与抑郁风险增加相关（≥5 年的 aHR 为 1.30）。母乳喂养时间和 OC 使用时间与抑郁呈 U 型弱相关，而产次与抑郁无显著相关性。
晚初潮、早绝经和 MHT 的使用与绝经后女性抑郁风险增加有关。
