Dysmenorrhea increased the risk of postpartum depression in Chinese Han parturients

Abstract

Several studies have shown that dysmenorrhea increased the risk of depression. However, the association between dysmenorrhea and postpartum depression (PPD) is unclear. The purpose of this study is to evaluate the effects of dysmenorrhea on the development of PPD among Chinese women. A case-control study was performed on parturients who delivered from January 1, 2016, to December 31, 2016, at Bao an Maternal and Child Health Hospital in Shenzhen, China. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for maternal postpartum depression. Logistic regression models were used to examine the association between dysmenorrhea and the risk of PPD. A total of 360 women including 120 cases and 240 controls were enrolled. Our study showed that parturients with PPD had a higher percentage of dysmenorrhea than women without PPD (64.2% vs 47.9%, P = 0.004). In univariate analysis, we observed that dysmenorrhea increased the risk for PPD (OR = 1.95; 95% CI: 1.24–3.06; P = 0.004). In the fully adjusted model, dysmenorrhea was still significantly associated with an increased risk of PPD (OR = 2.45; 95% CI: 1.36–4.54; P = 0.003). Our data confirmed that dysmenorrhea may be a risk factor for PPD. Therefore, screening for postpartum depression should be considered in parturients with a history of dysmenorrhea.

Significant Increase in Depression in Women With Primary Dysmenorrhea: A Systematic Review and Cumulative Analysis

“…A total of 4,691 subjects and 2,130 dysmenorrhea cases were involved. Of the 10 included studies evaluated, 6 studies ( 14 – 19 ) provided the dichotomous variables (cases of depression) that could be calculated for the pooled RR via a meta-analysis, while 4 studies ( 20 – 23 ) provided the continuous variables (scores for depression), which were calculated for the pooled SMD. Among the 10 studies included in this meta-analysis, 5 studies ( 15 , 17 , 21 – 23 ) were cross-sectional designed and the remainder ( 14 , 16 , 18 – 20 ) were case-control designed.…”

“…The mean age in women with dysmenorrhea and women without dysmenorrhea was 18–50 years and 18–43 years, respectively. One trial was conducted in Hungary ( 14 ), one in Gambia ( 15 ), one in Georgia ( 16 ), one in China ( 19 ), two in Iran ( 17 , 21 ), two in Turkey ( 18 – 20 ), and two ( 22 , 23 ) in the USA. The age at menarche of the participants ranged from 12.4 ± 1.1 years to 13.5 ± 1.2 years.…”

“…Among the five cross-sectional studies, four studies ( 15 , 17 , 22 , 23 ) were assessed as moderate quality, and the remaining one study ( 21 ) was high quality ( Supplementary Table 1 ). In the five case-control studies, four studies ( 14 , 16 , 18 , 20 ) were judged to moderate quality, and only one study ( 19 ) was evaluated as high quality ( Supplementary Table 2 ).…”

“…Though the present meta-analysis suggested that primary dysmenorrhea elevated the risk of depressive symptoms, the clear-cut etiology for such association has not yet been fully established ( 14 , 15 ). Progressed researches indicate multifactorial mechanisms may contribute to the high prevalence of depressive disorder in women with primary dysmenorrhea, including recurrent and chronic menstrual pain ( 19 ), hormone-responsive disorders ( 20 ), increased pro-inflammatory cytokines ( 14 , 16 ), and poor school or social performances ( 20 , 21 ). These factors independently or collectively contribute to someone with primary dysmenorrhea are more liable to suffer from depression.…”

“…The search flowchart for identifying the eligible studies was shown in Figure 1. (14), one in Gambia (15), one in Georgia ( 16), one in China (19), two in Iran (17,21), two in Turkey (18)(19)(20), and two (22,23) in the USA. The age at menarche of the participants ranged from 12.4 ± 1.1 years to 13.5 ± 1.2 years.…”