Department of Nursing, Xiamen Cardiovascular Hospital Xiamen University, Xiamen 361006, China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000,China.
J Psychosom Res. 2024 Dec;187:111881. doi: 10.1016/j.jpsychores.2024.111881. Epub 2024 Aug 6.
This cross-sectional research aimed to examine how reproductive factors influence depression and suicidal ideation among postmenopausal women.
Data from the 2007 to 2018 US National Health and Nutrition Examination Survey were analyzed for this study. The Patient Health Questionnaire (PHQ-9) was adopted to measure depression and suicidal ideation in the participants.
Out of 3076 participants, 9.5% (348/3076) experienced depression, and 3.4% (128/3076) reported suicidal ideation. Following the adjustment for confounding factors, premature menopause (OR = 1.81, 95% CI: 1.03-3.15) was significantly associated with an increased risk of depression. Moreover, postmenopausal women with a higher number of pregnancies exhibited a greater risk of depression (OR = 1.29, 95% CI: 1.09-1.53; P < 0.001). Conversely, a longer reproductive lifespan (OR = 0.96, 95% CI: 0.93-0.99) and a higher number of livebirths (OR = 0.68, 95% CI: 0.54-0.86; P < 0.001) were linked to a decreased risk of depression. Furthermore, the use of oral contraceptives (OR = 0.52, 95% CI: 0.28-0.97; P = 0.021) was significantly associated with a decreased likelihood of experiencing suicidal ideation, while the number of livebirths (OR = 0.68, 95% CI: 0.48-0.97; P = 0.018) exhibited a negative correlation with suicidal ideation.
Our results indicate that reproductive factors are significantly associated with the risk of depression and suicidal ideation in postmenopausal women. Further longitudinal studies with repeated measures of depression are necessary to establish causal relationships.
本横断面研究旨在探讨生殖因素如何影响绝经后妇女的抑郁和自杀意念。
本研究分析了 2007 年至 2018 年美国国家健康和营养调查的数据。采用患者健康问卷（PHQ-9）衡量参与者的抑郁和自杀意念。
在 3076 名参与者中，9.5%（348/3076）出现抑郁，3.4%（128/3076）报告有自杀意念。在调整混杂因素后，过早绝经（OR=1.81，95%CI：1.03-3.15）与抑郁风险增加显著相关。此外，妊娠次数较多的绝经后妇女抑郁风险更高（OR=1.29，95%CI：1.09-1.53；P<0.001）。相反，生殖寿命较长（OR=0.96，95%CI：0.93-0.99）和活产数较多（OR=0.68，95%CI：0.54-0.86；P<0.001）与抑郁风险降低相关。此外，口服避孕药的使用（OR=0.52，95%CI：0.28-0.97；P=0.021）与自杀意念的可能性降低显著相关，而活产数（OR=0.68，95%CI：0.48-0.97；P=0.018）与自杀意念呈负相关。
我们的研究结果表明，生殖因素与绝经后妇女的抑郁和自杀意念风险显著相关。需要进一步进行重复测量抑郁的纵向研究以确定因果关系。
