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Association of reproductive lifespan with depression in postmenopausal women from NHANES (2005-2018): A cross-sectional study
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DOI：10.1016/j.psychres.2026.117133.png)
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Abstract
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Background: Depression, a common mental health disorder, exerts substantial adverse effects on physical health and longevity. While reproductive factors have been established as determinants of depression in women, and the association between reproductive lifespan (RLS) -a critical indicator of reproductive health- and depression remains insufficiently elucidated. Methods: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Multiple imputation was used to handle missing covariate data. Multivariable logistic regression with five sequential adjustment models was used to estimate the association between RLS with depression. Restricted cubic spline (RCS) analysis was conducted to explore a potential nonlinear relationship between them. Sensitivity analyses were performed to assess the robustness of the findings. Results: The study included 7218 postmenopausal women, which, after weighting, represent a population of approximately 42,437,141 in the United States, with a depression prevalence of 10.07 %. The risk of depression decreased by 4 % for each additional year of RLS without covariate adjustment [odds ratio (OR) = 0.96, 95 % Confidence interval (CI): 0.95-0.97, P < 0.001]. However, in contrast to previous findings, no significant association was observed between RLS and depression risk after adjusted for demographics, lifestyle factors, comorbidities, reproductive variables, and female hormone use (OR=0.99, 95 % CI: 0.97-1.00, P = 0.122). These findings remained robust across sensitivity analysis. Conclusions: RLS was not found to be associated with depression in postmenopausal women in the United States. After adjustment for covariates, the initially observed inverse association was no longer significant. Further cohort studies are needed to explore the association between RLS and depression and its underlying mechanisms.
Keywords:
Reproductive lifespan (RLS)
Depression
NHANES
Cross-sectional study
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