产后荷尔蒙避孕药的使用和抑郁症的风险
Søren Vinther Larsen1,2, Brice Ozenne1,3, Anders Pretzmann Mikkelsen4,5
1Neurobiology Research Unit, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
JAMA network open
|March 31, 2025
概括
产后开始使用荷尔蒙避孕药 (HC) 与产后抑郁症的风险更高有关. 越早开始使用HC,相关的抑郁风险就越大,特别是在组合口服避孕药 (COC) 中.
科学领域:
- 生殖健康 生殖健康
- 心理健康 心理健康
- 临床流行病学临床流行病学
背景情况:
- 已知使用荷尔蒙避孕药 (HC) 与抑郁症有关.
- 产后期在女性中存在更高的抑郁症风险.
- 产后HC启动和抑郁症之间的关联仍然不清楚.
研究的目的:
- 调查在产后期开始使用荷尔蒙避孕药与12个月内出现抑郁症之间的关联.
- 分析不同类型的荷尔蒙避孕药及其特定风险.
主要方法:
- 基于人口的队列研究,使用丹麦全国性注册数据.
- 包括1997年至2022年间分娩的女性.
- 在产后12个月内对HC启动 (COCs,CNOCs,POPs,PNOCs) 和抑郁症诊断或抗抑郁药物处方进行时间变化的暴露分析.
主要成果:
- 开始使用荷尔蒙避孕药与49%的抑郁风险增加有关 (AHR1.49).
- 在产后12个月内,绝对抑郁症风险从1.36%增加到1.54%
- 联合口服避孕药 (COCs) 显示了更高的相关风险 (AHR 1.72),早期开始与更高的风险有关.
结论:
- 产后荷尔蒙避孕药的开始与抑郁症的风险增加有关.
- 风险似乎更高,更早启动,特别是对于COCs.
- 调查结果质疑,由于潜在的抑郁症发病率增加,产后立即开始常规使用荷尔蒙避孕药.
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