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Analysis of risk factors for postoperative depressive disorders in patients with intrauterine adhesions
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DOI：10.5498/wjp.v16.i3.112649.png)
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Abstract
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BACKGROUND Intrauterine adhesions (IUA) are a common gynecological condition that can significantly impact patients' reproductive health and psychological well-being. This study aimed to analyze the incidence and associated risk factors of postoperative depressive disorders in patients with IUA to provide evidence for clinical interventions. AIM To determine the incidence of postoperative depressive disorders in patients undergoing hysteroscopic adhesiolysis for IUA, identify independent risk and protective factors associated with depression development. METHODS A retrospective analysis was conducted on clinical data from 400 patients who underwent intrauterine adhesion lysis surgery at our hospital from January 2022 to December 2024. Demographic characteristics, medical history, surgical parameters, and follow-up outcomes were collected. The Self-Rating Depression Scale and Hamilton Depression Scale were used to assess depressive status before surgery and 3 months postoperatively. Univariate analysis and multivariate logistic regression were performed to determine independent risk factors for postoperative depressive disorders. RESULTS Among the 400 patients, 112 (28.0%) developed depressive disorders within 3 months after surgery. Multivariate analysis showed that age >= 35 years [odds ratio (OR) = 2.05, 95% confidence interval (CI): 1.27-3.32, P = 0.003], history of infertility (OR = 2.58, 95%CI: 1.66-4.01, P < 0.001), history of recurrent miscarriage (OR = 2.82, 95%CI: 1.73-4.59, P < 0.001), severe IUA (American Fertility Society classification grade III) (OR = 3.31, 95%CI: 1.94-5.65, P < 0.001), postoperative complications (OR = 2.47, 95%CI: 1.39-4.38, P = 0.002), and previous history of depression or anxiety (OR = 4.16, 95%CI: 2.24-7.74, P < 0.001) were independent risk factors for postoperative depressive disorders. Protective factors included higher education level (OR = 0.58, 95%CI: 0.37-0.92, P = 0.019), good social support (OR = 0.45, 95%CI: 0.28-0.74, P = 0.001), and normal menstruation within 3 months after surgery (OR = 0.40, 95%CI: 0.24-0.67, P < 0.001). CONCLUSION The incidence of postoperative depressive disorders in patients with intrauterine adhesions is relatively high and associated with multiple factors.
Keywords:
Intrauterine adhesions
Depression
Risk factors
Intrauterine adhesiolysis
Psychological health
Fertility
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