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. 2024 Dec 23;18(1):24.
doi: 10.1186/s13030-024-00323-7.

Association of preconception premenstrual disorders with perinatal depression: an analysis of the perinatal clinical database of a single Japanese institution

Takuma Ohsuga  1 , Miho Egawa  2 , Kaori Tsuyuki  1 , Akihiko Ueda  1 , Maya Komatsu  1 , Yoshitsugu Chigusa  1 , Haruta Mogami  1 , Masaki Mandai  1
Affiliations

Association of preconception premenstrual disorders with perinatal depression: an analysis of the perinatal clinical database of a single Japanese institution

Takuma Ohsuga et al. Biopsychosoc Med. .

Abstract

Background: Recent studies have identified premenstrual disorders (PMDs) as a risk factor for postpartum depression. However, routine screening for preconception PMDs is not yet common in Japan. This study investigated the association between preconception PMDs and perinatal depression in a single tertiary care setting.

Methods: We analyzed data from pregnant women who gave birth at Kyoto University Hospital between April 2020 and October 2023. The Premenstrual Symptoms Screening Tool was administered at the first postconception visit to retrospectively assess PMD status before the current pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) was administered during pregnancy and one month postpartum as a prospective measure of perinatal depression. EPDS cutoff values were set at 12/13 during pregnancy and 8/9 at one month postpartum.

Results: Of the 781 women analyzed, 53 had preconception PMD. Univariate and multivariate logistic regression analyses revealed that preconception PMD was associated with an EPDS score of ≥ 13 during pregnancy, with a crude odds ratio (OR) of 5.78 (95% confidence interval [CI]: 2.70-11.75) and an adjusted OR of 3.71 (95% CI: 1.54-8.35). For an EPDS score of ≥ 9 at 1 month postpartum, the crude OR was 3.36 (95% CI: 1.79-6.12) and the adjusted OR was 2.16 (95% CI: 1.04-4.35).

Conclusions: Our findings indicate that preconception PMDs are a significant risk factor for both depression during pregnancy and postpartum depression. These results support the implementation of preconception PMD screening during antenatal checkups as a preventive measure and to identify women in need of early mental health care.

Keywords: Perinatal mental health; Postpartum depression; Preconception; Premenstrual disorders; Premenstrual dysphoric disorder; Premenstrual syndrome; Prenatal depression.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was reviewed and approved by the Ethics Committee of Kyoto University Graduate School and Faculty of Medicine (Approval No. R2262). Informed consent was obtained through an opt-out system, with details provided in the information disclosure documents. Consent for publication: Not applicable. Competing interests: Not applicable.

Figures

Fig. 1
Fig. 1
Flowchart of patient inclusion. Abbreviations: EPDS, Edinburgh Postnatal Depression Scale; PMDD, premenstrual dysphoric disorder; PMDs, premenstrual disorders; PMS, premenstrual syndrome; PSST, Premenstrual Symptoms Screening Tool
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