Department of Gynecology and Obstetrics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215123, PR China..
Department of Biostatistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu 215123, PR China.
J Affect Disord. 2025 Jan 15;369:615-624. doi: 10.1016/j.jad.2024.10.037. Epub 2024 Oct 15.
Limited research has examined the association between the number of live births and bipolar disorder and major depression (BDMD). This study aims to investigate the relationship between the number of live births and BDMD among women in the UK, providing a theoretical basis for reproductive decision-making.
This cross-sectional study utilized data from >55,000 women in the UK Biobank. Inverse probability treatment weighting (IPTW) logistic regression models were employed to reduce bias and confounding. Multivariate logistic regression was applied to examine the relationship between live births and BDMD, while restricted cubic spline regression was utilized to analyze the nonlinear association between the number of live births and BDMD. Subgroup analyses were conducted, stratifying by age, BMI, spontaneous abortion, induced abortion, and spontaneous abortion.
The IPTW-multivariate logistic regression analysis indicated that live births serve as an independent protective factor against BDMD. In IPTW-multivariate Model 4, the odds ratio (OR) for the live births group was 0.71 (95 % CI 0.69-0.73, P < 0.001). A significant nonlinear relationship was identified between the number of live births and the risk of BDMD. Additionally, it was found that women with two live births exhibited the lowest risk of BDMD.
Our study demonstrated that live births are an independent protective factor against BDMD. This research holds particular significance in the context of globally declining fertility rates and the increasing prevalence of mental disorders. It provides guidance for women on fertility decisions amid declining global fertility rates and increasing mental health issues.
有限的研究探讨了活产次数与双相情感障碍和重度抑郁症(BDMD)之间的关联。本研究旨在调查英国女性活产次数与 BDMD 之间的关系,为生殖决策提供理论依据。
这是一项横断面研究,利用了英国生物库中超过 55000 名女性的数据。采用逆概率处理加权(IPTW)逻辑回归模型来减少偏差和混杂。多变量逻辑回归用于检验活产次数与 BDMD 之间的关系,同时应用受限立方样条回归分析活产次数与 BDMD 之间的非线性关系。进行了亚组分析,按年龄、BMI、自然流产、人工流产和自然流产进行分层。
IPTW-多变量逻辑回归分析表明,活产次数是 BDMD 的独立保护因素。在 IPTW-多变量模型 4 中,活产组的比值比(OR)为 0.71(95%CI 0.69-0.73,P<0.001)。活产次数与 BDMD 风险之间存在显著的非线性关系。此外,发现有两次活产的女性 BDMD 风险最低。
我们的研究表明,活产次数是 BDMD 的独立保护因素。在全球生育率下降和精神障碍患病率上升的背景下,这一研究具有特殊意义。它为全球生育率下降和精神健康问题增加的情况下,女性的生育决策提供了指导。