Associations of Infertility With Depressive Symptom Change Across Specific Life Stages (Pregnancy, Postpartum, and Midlife) Among Parous Women.

IF 2.7 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Paediatric and perinatal epidemiology Pub Date : 2025-05-01 DOI:10.1111/ppe.70026

Melissa Pérez Capotosto, Ann Wolbert Burgess, Sheryl L Rifas-Shiman, Victoria Fitz, Jan Shifren, Jorge E Chavarro, Emily Oken

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引用次数: 0

Abstract

Background: Limited longitudinal data exist on the associations of infertility with depressive symptoms across the lifecourse.

Objectives: To investigate how depressive symptoms change across specific life stages (pregnancy, postpartum, and midlife), with a focus on the differences between women with and without a history of infertility before index pregnancy.

Methods: Women enrolled in Project Viva (1999-2002) during early pregnancy (mean [SD] age 32.5 [4.7] years) completed the Edinburgh Postnatal Depression Scale (EPDS) in mid-pregnancy (median 27.9 weeks gestation) and at 6 months postpartum, and completed the Patient Health Questionnaire (PHQ-9) in midlife (2017-2021, 50.9 [5.1] years). We converted EPDS and PHQ-9 scores to externally standardised T-scores (mean = 50, SD = 10). We defined infertility before index pregnancy as ≥ 6 cycles to achieve pregnancy if ≥ 35 years of age or ≥ 12 cycles to achieve pregnancy if < 35 years of age, or claims for infertility treatments or prescriptions abstracted from medical records. We performed adjusted linear regression models to examine associations of infertility with depressive symptoms across the three-time spans (pregnancy-postpartum, postpartum-midlife, and pregnancy-midlife).

Results: Among 1368 participants, 281 (21%) experienced infertility at index pregnancy. Infertility was associated with a 1.83- point increase in depressive symptoms (T-score) between the postpartum period and midlife (adjusted $β$ 1.83, 95% confidence interval [CI] 0.00, 3.66). Infertility was unrelated to change in depressive symptoms between pregnancy and postpartum (adjusted $β$ 0.02, 95% CI -1.24, 1.28) or pregnancy and midlife (adjusted $β$ 1.30, -0.64, 3.23).

Conclusions: The experience of infertility among parous women is associated with a greater increase in depressive symptoms between the post-partum period and midlife.

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生育妇女在特定生命阶段（妊娠、产后和中年）不孕与抑郁症状变化的关系

背景：关于不孕症与抑郁症状在整个生命过程中的关联的纵向数据有限。目的：调查抑郁症状在特定生命阶段（妊娠、产后和中年）的变化，重点关注在指数妊娠前有和没有不孕史的妇女之间的差异。方法：参与Viva项目（1999-2002）的妇女在妊娠早期（平均[SD]年龄32.5[4.7]岁）在妊娠中期（中位妊娠27.9周）和产后6个月完成爱丁堡产后抑郁量表（EPDS），并在中年（2017-2021年，50.9[5.1]岁）完成患者健康问卷（PHQ-9）。我们将EPDS和PHQ-9评分转换为外部标准化t评分（mean = 50, SD = 10）。我们将指数妊娠前不孕症定义为：年龄≥35岁≥6个妊娠周期或年龄≥12个妊娠周期%) experienced infertility at index pregnancy. Infertility was associated with a 1.83- point increase in depressive symptoms (T-score) between the postpartum period and midlife (adjusted β $$ \beta $$ 1.83, 95% confidence interval [CI] 0.00, 3.66). Infertility was unrelated to change in depressive symptoms between pregnancy and postpartum (adjusted β $$ \beta $$ 0.02, 95% CI -1.24, 1.28) or pregnancy and midlife (adjusted β $$ \beta $$ 1.30, -0.64, 3.23).Conclusions: The experience of infertility among parous women is associated with a greater increase in depressive symptoms between the post-partum period and midlife.

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来源期刊

Paediatric and perinatal epidemiology 医学-妇产科学

CiteScore

5.40

自引率

7.10%

发文量

审稿时长

1 months

期刊介绍： Paediatric and Perinatal Epidemiology crosses the boundaries between the epidemiologist and the paediatrician, obstetrician or specialist in child health, ensuring that important paediatric and perinatal studies reach those clinicians for whom the results are especially relevant. In addition to original research articles, the Journal also includes commentaries, book reviews and annotations.