Associations of Education Attainment With Postpartum Depression and the Mediating Exploration: A Mendelian Randomization Study

IF 3.3 2区医学 Q1 PSYCHIATRY

Depression and Anxiety Pub Date : 2025-02-20 DOI:10.1155/da/8835118

Xuanping Wang, Fang-Yue Zhou, Yanhui Hao, Jiaying Wu, Kaizhen Su, Si-Yue Chen, Wen Yu, Chen Zhang, Yan-Ting Wu, He-Feng Huang

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引用次数: 0

Abstract

Background: Many studies have explored the relationship between education and postpartum depression (PPD), with inconsistent results. Our study is to identify which education-related factors (education attainment, qualifications, cognitive performance) played the predominant role in PPD using Mendelian randomization (MR) analysis. Then, we explored the factors that may mediate the effect of education on PPD.

Method: We performed two-sample multivariable Mendelian randomization (MVMR) to assess the independent impact of education-related factors on PPD. Based on the literature review, three mediating factors that may play a role in the path of education attainment and PPD were involved in mediation analysis, including childbearing age, neuroticism score, and average total household income before tax. Then, we used two-step MR and MVMR to estimate the indirect effect of these mediators.

Results: We identified genetically predicted 1-SD (3.71 years) higher education attainment (OR: 0.632; [95% confidential interval (CI): 0.464–0.860]); qualifications (OR: 0.418; [95% CI: 0.245–0.714]); or cognitive performance (OR: 0.770; [95% CI: 0.652–0.909]) was associated with lower risk of PPD, and the causal effects of education attainment (OR: 0.407; [95% CI: 0.214–0.773]) on PPD were independent of qualifications and cognition. Childbearing age (β: −0.497; [95% CI: −0.788−0.238]; p < 0.001) and neuroticism score (β: −0.07; [95% CI: −0.120−0.030]; p < 0.001) were identified as mediators of the association between education attainment and PPD.

Conclusions: These results suggested the predominant impact of education attainment on PPD independent of qualifications and cognition. Education level mainly affects PPD by changing the childbearing age.

Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR2000033433

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教育程度与产后抑郁的关系及其中介探索：一项孟德尔随机化研究

背景：许多研究探讨了教育与产后抑郁（PPD）之间的关系，但结果并不一致。我们的研究是利用孟德尔随机化（MR）分析来确定哪些教育相关因素（教育程度、资格、认知表现）在PPD中起主导作用。然后，我们探讨了可能介导教育对PPD影响的因素。方法：采用双样本多变量孟德尔随机化（MVMR）评估教育相关因素对PPD的独立影响。在文献回顾的基础上，我们对育龄、神经质评分和税前家庭平均总收入这三个可能在受教育程度与产后抑郁的路径中起作用的中介因素进行了中介分析。然后，我们使用两步磁共振和MVMR来估计这些介质的间接影响。结果：我们确定了遗传预测的1-SD（3.71年）高等教育程度(OR: 0.632；[95%置信区间（CI）： 0.464-0.860]；学历(OR: 0.418；[95% ci: 0.245-0.714])；或认知表现(or: 0.770；[95% CI: 0.652-0.909])与PPD风险较低以及受教育程度的因果效应相关(OR: 0.407；[95% CI: 0.214-0.773])对PPD的影响与资质和认知无关。生育年龄(β:−0.497；[95% ci:−0.788−0.238]；p & lt;0.001)和神经质评分(β:−0.07；[95% ci:−0.120−0.030]；p & lt;0.001)被确定为受教育程度与PPD之间关联的中介因子。结论：受教育程度是影响PPD的主要因素，与学历和认知无关。教育程度主要通过改变生育年龄影响PPD。试验注册：中文临床试验注册号：ChiCTR2000033433

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来源期刊

Depression and Anxiety 医学-精神病学

CiteScore

15.00

自引率

1.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.