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. 2024 Nov 5:33:e55.
doi: 10.1017/S2045796024000374.

Association of a history of depression with infertility, miscarriage and stillbirth: a longitudinal cohort study

Chen Liang  1 , Hsin-Fang Chung  1 , Annette J Dobson  1 , Gita D Mishra  1
Affiliations

Association of a history of depression with infertility, miscarriage and stillbirth: a longitudinal cohort study

Chen Liang et al. Epidemiol Psychiatr Sci. .

Abstract

Aims: The role of depression in subsequent infertility, miscarriage and stillbirth remains unclear. This study aimed to examine the association of a history of depression with these adverse outcomes using a longitudinal cohort study of women across their reproductive life span.

Methods: This study used data from participants in the Australian Longitudinal Study on Women's Health who were born in 1973-1978. Participants (N = 8707) were followed up every 3 years from 2000 (aged 22-27) to 2018 (aged 40-45). Information on a diagnosis of depression was collected from each survey, and antidepressant medication use was identified through pharmaceutical prescription data. Histories of infertility, miscarriage, and stillbirth were self-reported at each survey. Time-lagged log-binomial models with generalized estimating equations were used to assess the association of a history of depression up to and including in a given survey with the risk of fertility issues in the next survey.

Results: Women with a history of depression (excluding postnatal depression) were at higher risk of infertility [risk ratio (RR) = 1.34, 95% confidence interval (CI): 1.21-1.48], miscarriage (RR = 1.22, 95%CI: 1.10-1.34) and recurrent miscarriages (≥2; RR = 1.39, 95%CI: 1.17-1.64), compared to women without a history of depression. There were too few stillbirths to provide clear evidence of an association. Antidepressant medication use did not affect the observed associations. Estimated RRs of depression with infertility and miscarriage increased with age.

Conclusions: A history of depression was associated with higher risk of subsequent infertility, miscarriage and recurrent miscarriages.

Keywords: depression; infertility; longitudinal study; miscarriage; stillbirth.

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Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
One-survey lagged data structure with inclusion and exclusion criteria.
Figure 2.
Figure 2.
Example of one-survey lagged data contributing to the analyses of miscarriage and recurrent miscarriages.
Figure 3.
Figure 3.
The associations of history of depression with the risk of subsequent infertility, miscarriage and recurrent miscarriages by survey. (a) infertility, (b) miscarriage and (c) recurrent miscarriages.
See this image and copyright information in PMC

References

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    1. Centers for disease control and prevention (2024) About stillbirth. https://www.cdc.gov/stillbirth/about/index.html#:~:text=A%20stillbirth%2... [Acceseed on 24 October 2024].

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