Association of perinatal depression with vasomotor symptoms during midlife: A prospective community-based cohort study

OBJECTIVES: To explore the association between perinatal depression and midlife vasomotor symptoms. STUDY DESIGN: We analyzed a subset of 1479 women from the All Our Families Study, a prospective cohort of women (mean age 31.2 years at enrollment) who delivered singleton pregnancies in Calgary, Canada, between 2008 and 2010. Data have been collected through regular self-report questionnaires, most recently in women's midlife at 12-14 years after the index birth (mean age 44.0 years). Perinatal depression was measured using the Edinburgh Postnatal Depression Scale screening tool at four time points between pregnancy and 1 year postpartum. MAIN OUTCOME MEASURES: The primary outcome was vasomotor symptoms (hot flashes and night sweats) ≥1 day in the past two weeks analyzed using modified Poisson regression to estimate adjusted risk ratios (ARR) and 95% confidence intervals (95% CI) controlling for baseline maternal age, race/ethnicity, education, parity, body mass index, and smoking status. RESULTS: Overall, 29.0% of women experienced perinatal depression during the index birth. Women with perinatal depression were more likely to report vasomotor symptoms (44.1%) during midlife than those without perinatal depression (38.1%; ARR 1.14, 95% CI 1.00, 1.30). This association was stronger for frequent vasomotor symptoms ≥6 days in the past two weeks (ARR 1.52, 95% CI 1.14, 2.04); was generally robust across timing of perinatal depression, parity, and menopausal status; and was stronger when followed by persistent depression over study follow-up. CONCLUSIONS: Perinatal depression may represent a novel risk factor for frequent vasomotor menopausal symptoms warranting additional study.