Zhang Chenglin, Yang Jiong, Yang Weili, An Jianmin, Cao Ping
Department of Pediatrics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Pediatric Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xi'an, 710004, Shaanxi, China.
Arch Womens Ment Health. 2025 Apr 2. doi: 10.1007/s00737-025-01582-1.
Age at menarche may influence the onset of depression later in life. We aim to assess the association between early/late menarche and depressive outcomes in females by updating a systematic review and meta-analysis.
The search of the original systematic review was updated for studies published in PubMed, Embase, and Cochrane Library from 2013 to 2023. The early/late and on-time menarche divisions were generally based on each study. Depression or depressive symptoms could be measured through various validated tools and diagnostic criteria. We assessed the quality of the evidence using the GRADE approach and performed a random-effect meta-analysis with age at menarche and the cases of depression as outcomes.
We included eight cohort and three cross-sectional studies (138,819 participants). Females with early menarche were more likely to have depression later in life compared with those who had on-time menarche (early vs. on-time menarche: odds ratio (OR) = 1.11; 95% confidence interval (CI): 1.03, 1.20; I = 44.5%). We found a null association between late menarche and depression for females (late vs. on-time menarche: odds ratio (OR) = 1.00; 95% confidence interval (CI): 0.87, 1.15; I = 73.2%). Sensitivity analyses showed that the results were robust. The quality of the available evidence was rated as very low.
Existing evidence suggests that early menarche may be associated with an increased risk of depression in females. But it remains unclear about late menarche. More high-quality studies are warranted.
初潮年龄可能会影响日后生活中抑郁症的发病。我们旨在通过更新一项系统评价和荟萃分析，评估女性初潮过早/过晚与抑郁结局之间的关联。
对原始系统评价的检索更新为2013年至2023年在PubMed、Embase和Cochrane图书馆发表的研究。初潮过早/过晚和适时初潮的划分通常依据每项研究。抑郁或抑郁症状可通过各种经过验证的工具和诊断标准进行测量。我们采用GRADE方法评估证据质量，并以初潮年龄和抑郁症病例为结局进行随机效应荟萃分析。
我们纳入了八项队列研究和三项横断面研究（138,819名参与者）。与适时初潮的女性相比，初潮过早的女性在日后生活中患抑郁症的可能性更大（初潮过早与适时初潮：比值比（OR）=1.11；95%置信区间（CI）：1.03，1.20；I²=44.5%）。我们发现女性初潮过晚与抑郁之间无关联（初潮过晚与适时初潮：比值比（OR）=1.00；95%置信区间（CI）：0.87，1.15；I²=73.2%）。敏感性分析表明结果具有稳健性。现有证据的质量被评为极低。
现有证据表明，初潮过早可能与女性患抑郁症的风险增加有关。但初潮过晚的情况仍不清楚。需要更多高质量的研究。
