Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum
Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum
复制标题
DOI：
10.1530/eje.0.1450579
复制
发表时间：
2001-11-01
影响因子：
5.8
通讯作者：
Pop, VJ
中科院分区：
文献类型：
--
作者：
Kuijpens, JL;Vader, HL;Pop, VJ
目的：抑郁症在许多情况下没有得到充分的诊断。因此，问题是是否存在抑郁症的标记。我们调查了是否在怀孕期间甲状腺过氧化物酶抗体（TPOAbs）的存在可以被视为产后第一年抑郁症的标志，特别是与（显性或亚临床）甲状腺功能障碍和抑郁症的其他决定因素。设计：这项工作是一项前瞻性观察研究。患者：一组310名女性（居住在荷兰东南部的Kempen地区）在妊娠12周和32周以及产后4周、12周、20周、28周和36周进行了访问。在每次访视时，进行TSH、游离甲状腺素和TPOAb检测，询问与抑郁症相关的决定因素，并评估抑郁症（根据研究诊断标准）。多元Logistic回归分析，以确定独立的危险因素（比值比，OR）抑郁症在妊娠期和/或产后depress.Results：数据为291名妇女可用于分析; 41名妇女（14.1%）有TPOAbs在一个或多个时间点，和117名妇女（40.1%）有抑郁症在一个或多个时间点产后。多元Logistic回归分析显示TPOAb与妊娠12周、产后4周和12周抑郁症的发生独立相关（OR，95%可信区间分别为2.4（1.1-6.0）、3.8（1.3-7.3）和3.6（1.2-7.1））。在排除了妊娠12周时抑郁的妇女（n = 70）后，发现妊娠早期TPOAb的存在仍然与产后抑郁的发生有关（OR，95%可信区间：2.8（1.7 - 4.5）;在排除了早期有抑郁症的妇女（n = 51）后，妊娠早期的TPOAb仍然与产后抑郁症有关（OR，95%置信区间：2.9（1.8 - 4.3）。结论：妊娠期间TPOAbs的存在与产后期间随后抑郁症的发生相关，因此可被视为抑郁症的标志物。
Objective: Depression is not adequately diagnosed in many cases. Therefore, the question arises as to whether markers exist for depression. We investigated whether the presence of thyroperoxidase antibodies (TPOAbs) during pregnancy can be regarded as a marker for depression in the first year postpartum, particularly in relation to (overt or subclinical) thyroid dysfunction and other determinants of depression.Design: This work was a prospective observational study.Patients: A cohort of 310 unselected women (residing in the Kempen Region, southeastern Netherlands) were visited at 12 and 32 weeks gestation and at 4, 12, 20, 28 and 36 weeks postpartum.Methods: At each visit, TSH, free thyroxine and TPOAb testing was performed, determinants associated with depression were asked for, and depression was assessed (according to the Research Diagnostic Criteria). Multiple logistic regression was performed to determine independent risk factors (odds ratios, ORs) for depression in gestation and/or postpartum depression.Results: Data for 291 women were available for analysis; 41 women (14.1%) had TPOAbs at one or more time points, and 117 women (40.1%) had depression at one or more time points postpartum. The multiple logistic regression analysis showed that TPOAbs were independently associated with depression at 12 weeks gestation and at 4 and 12 weeks postpartum (OR, 95% confidence interval: 2.4 (1.1-6.0), 3.8 (1.3-7.3) and 3.6 (1.2-7.1) respectively). After the exclusion of women who were depressed at 12 weeks gestation (n = 70), the presence of TPOAbs during early pregnancy was still found to be associated with the development of postpartum depression (OR, 95% confidence interval: 2.8 (1.7-4.5); after exclusion of women who had had depression in earlier life (n = 51), TPOAb during early gestation was still associated with postpartum depression (OR, 95% confidence interval: 2.9 (1.8-4.3).Conclusions: The presence of TPOAbs during gestation is associated with the occurrence of subsequent depression during the postpartum period and as such can be regarded as a marker for depression.