各种形式的流产以及晚年抑郁和焦虑的风险。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-06-19 DOI:10.1016/j.jad.2025.119728

Ying Hu , Xuan Wang , Shuqi Zhu , Danqing Chen , Hao Ma , Zhaoxia Liang

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引用次数: 0

摘要

背景：各种形式的流产（自然流产、死产和人工流产）与以后生活中抑郁和焦虑风险之间的长期关联尚不清楚。目的：我们前瞻性地研究自然流产、死胎和人工流产与抑郁和焦虑风险的长期关系。研究设计：共有175,614名来自英国生物银行的有妊娠史且无抑郁或焦虑基线的参与者被纳入研究。Cox比例风险模型用于评估各种形式的流产与抑郁和焦虑风险之间的关系。结果：在12.3 年的中位随访期间，记录了4806例抑郁事件和5601例焦虑事件。在调整了生殖因素、生活方式因素、社会支持因素和其他协变量后，各种形式的流产与抑郁和焦虑的风险有不同的关联。人工流产与抑郁、焦虑风险相关性最强；接着是自然流产。例如，每增加一次人工流产与焦虑风险增加12% %显著相关（hr, 95 % CI, 1.12, 1.06-1.18），而每增加一次自然流产仅与焦虑风险增加4% %相关（hr, 95 % CI, 1.04, 1.00-1.07）。死产与较高的抑郁或焦虑风险无关。此外，我们发现人工流产与抑郁风险之间的关联在已产妇女中比未产妇女更为明显（P-interaction = 0.013）。结论：自然流产、死产和人工流产与抑郁和焦虑风险的相关性不同。

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Various forms of pregnancy losses and risks of depression and anxiety in later life

Background

The long-term associations between various forms of pregnancy losses (spontaneous miscarriage, stillbirth, and induced abortion) and risks of depression and anxiety in later life remains unclear.

Objective

We prospectively investigated the long-term associations of spontaneous miscarriage, stillbirth, and induced abortion with the risks of depression and anxiety.

Study design

A total of 175,614 participants with pregnancy history and free of depression or anxiety at baseline from the UK Biobank were included. Cox proportional hazard models were used to evaluate the associations between various forms of pregnancy losses and risks of depression and anxiety.

Results

During a median follow-up of 12.3 years, 4806 depression incidents and 5601 anxiety incidents were documented. After adjustment for reproductive factors, lifestyle factors, social support factors, and other covariates, various forms of pregnancy losses had differential associations with the risks of depression and anxiety. Induced abortion showed the strongest association with depression and anxiety risk; followed by spontaneous miscarriage. For example, each additional induced abortion was significantly associated with a 12 % higher risk of anxiety (HRs, 95 % CI, 1.12, 1.06–1.18), whereas each additional spontaneous abortion was associated with only a 4 % higher risk of anxiety (HRs, 95 % CI, 1.04, 1.00–1.07).Stillbirth was not associated with a higher risk of depression or anxiety. Moreover, we found that the association between induced abortion and risk of depression was more pronounced in parous women than nulliparous women (P-interaction = 0.013).

Conclusions

Spontaneous miscarriage, stillbirth, and induced abortion are differently associated with risks of depression and anxiety.

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.