Department of Anesthesiology, Peking University Third Hospital, No. 49, North Garden Street, Haidian District, Beijing, 100191, China.
Department of Obstetrics and Gynecology, Wuxi No.2 People's Hospital, 585 Xingyuan North Road, Liangxi District, Wuxi, Jiangsu, 214000, China.
BMC Public Health. 2024 Oct 10;24(1):2761. doi: 10.1186/s12889-024-20213-5.
This study aims to explore the relationship between female reproductive factors (age at first birth (AFB), age at last birth (ALB), gravidity, and number of live birth (NLB)) and prevalence of depression among the US women.
The relationship between AFB, ALB, gravidity, and NLB with the prevalence of depression was explored using publicly available data from the National Health and Nutrition Examination Survey 2005-2018. This cross-sectional study included female participants aged 20 years and older, with reproductive factors and depressive symptoms reported by the participants. Depression was evaluated using the Patient Health Questionnaire-9, with a score of ≥ 10 representing major depression disorder. Weighted multivariable logistic regression and restricted cubic splines (RCS) were utilized to explore the association of AFB, ALB, gravidity and NLB with depression.
In this study of 11,488 US women, 1,332 (11.6%) women had depression. Compared to the reference group of women with AFB under 18 years, the fully adjusted ORs and 95% CIs for depression were 0.83 (95% CI: 0.68-0.99), 0.75 (95% CI: 0.60-0.95), and 0.69 (95% CI: 0.51-0.93) for women with AFB of 21-23, 24-26, and 27-29 years, respectively. Furthermore, women with five or more pregnancies had a significantly higher prevalence of depression compared to those with two or fewer pregnancies (OR = 1.20, 95% CI: 1.01-1.42). RCS models demonstrated linear associations of ALB, gravidity and NLB with the prevalence of depression. Additionally, the RCS analysis revealed a roughly L-shaped relationship between AFB and prevalence of depression.
Women with later AFB are associated with a decreased prevalence of depression, while multiple pregnancies are associated with an increased prevalence of depression. These findings suggest that reproductive factors should be considered when screening for and developing preventive strategies for depression.
本研究旨在探讨美国女性生殖因素（初育年龄（AFB）、末次生育年龄（ALB）、生育次数和活产数（NLB））与抑郁患病率之间的关系。
利用 2005-2018 年全国健康与营养调查的公开数据，探讨 AFB、ALB、生育次数和 NLB 与抑郁患病率之间的关系。本横断面研究纳入了年龄在 20 岁及以上、有生殖因素和抑郁症状报告的女性参与者。使用患者健康问卷-9 评估抑郁，得分≥10 分表示患有重度抑郁症。采用加权多变量逻辑回归和限制性立方样条（RCS）探讨 AFB、ALB、生育次数和 NLB 与抑郁的关系。
在这项对 11488 名美国女性的研究中，1332 名（11.6%）女性患有抑郁症。与 AFB 小于 18 岁的女性参考组相比，AFB 为 21-23 岁、24-26 岁和 27-29 岁的女性的完全调整后 OR 值和 95%CI 分别为 0.83（95%CI：0.68-0.99）、0.75（95%CI：0.60-0.95）和 0.69（95%CI：0.51-0.93）。此外，生育次数为 5 次或更多的女性与生育次数为 2 次或更少的女性相比，抑郁的患病率显著更高（OR=1.20，95%CI：1.01-1.42）。RCS 模型显示 ALB、生育次数和 NLB 与抑郁患病率呈线性关系。此外，RCS 分析显示 AFB 与抑郁患病率之间呈大致 L 形关系。
AFB 较晚的女性患抑郁症的患病率较低，而多次妊娠与抑郁症的患病率增加有关。这些发现表明，在筛查和制定预防抑郁症的策略时，应考虑生殖因素。
