Obstetrics, Gynecology and Reproduction Research, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, Jiangsu, 214000, P.R. China.
Department of Medical Education, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, Jiangsu, 214000, P.R. China.
BMC Psychiatry. 2024 Jul 23;24(1):526. doi: 10.1186/s12888-024-05948-0.
Depression is a common mental disorder with a much higher prevalence in women than in men. Although there has been a gradual increase in research on the association between reproductive health and depression, there is still some inconsistency in the evidence of the relationship between pregnancy loss and depression. This study aimed to investigate the relationship between pregnancy loss and depressive symptoms.
We analyzed data from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), which included female participants aged 20 to 80 years. Pregnancy loss was determined based on participants' self-reported number of pregnancies and pregnancy outcomes. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9, score ≥ 10). Multivariate logistic regression, smoothed curve fitting, and generalized additive modeling were used to examine the association between pregnancy loss and depression. We also performed sensitivity analyses and subgroup analyses to verify the robustness and specificity of the findings.
A total of 12,873 female participants were included in our study, of which 1,595 (12.39%) were categorized as depressed. Multivariate logistic regression results indicated that experiencing a pregnancy loss increased the risk of prevalence of depression in women (for 1 loss: OR = 1.31, 95% CI 1.15,1.50; for 2 or more losses: OR = 1.58, 95% CI 1.38, 1.81). When sensitivity analyses were performed, an association between pregnancy loss and depression was found in both multivariate linear regressions with PHQ-9 scores as a continuous variable and multivariate logistic regressions with a threshold of 5 PHQ-9 scores. The association between pregnancy loss and depression remained stable across subgroups.
Pregnancy loss correlated with elevated PHQ-9 scores and a heightened risk of depression in adult women across the United States. Focusing on the incidence of adverse pregnancy events in the female population may help prevent or early recognize the onset of depression.
抑郁症是一种常见的精神障碍，女性的患病率明显高于男性。尽管人们对生殖健康与抑郁症之间的关系进行了逐步深入的研究，但妊娠丢失与抑郁症之间关系的证据仍存在一些不一致。本研究旨在调查妊娠丢失与抑郁症状之间的关系。
我们分析了 2007 年至 2020 年全国健康与营养调查（NHANES）的数据，该调查包括年龄在 20 至 80 岁之间的女性参与者。妊娠丢失是根据参与者报告的妊娠次数和妊娠结局来确定的。抑郁症状采用患者健康问卷（PHQ-9，得分≥10）进行测量。采用多变量逻辑回归、平滑曲线拟合和广义加性模型来检验妊娠丢失与抑郁之间的关系。我们还进行了敏感性分析和亚组分析，以验证结果的稳健性和特异性。
共有 12873 名女性参与者纳入本研究，其中 1595 名（12.39%）被归类为抑郁。多变量逻辑回归结果表明，妊娠丢失增加了女性抑郁发病的风险（1 次丢失：OR=1.31，95%CI 1.15，1.50；2 次或以上丢失：OR=1.58，95%CI 1.38，1.81）。当进行敏感性分析时，我们发现妊娠丢失与抑郁之间存在关联，这在以 PHQ-9 得分为连续变量的多变量线性回归和以 PHQ-9 得分为 5 分为阈值的多变量逻辑回归中均成立。在亚组分析中，妊娠丢失与抑郁之间的关联仍然稳定。
在美国成年女性中，妊娠丢失与 PHQ-9 评分升高和抑郁风险增加相关。关注女性人群中不良妊娠事件的发生率可能有助于预防或早期识别抑郁症的发生。
