通讯作者: 梁雪梅, 1105362215@qq.com

DOI：10.12201/bmr.202601.00058

The Impact of Oral Contraceptives on Depression: A Meta-Analysis

• 摘要：目的口服避孕药是全球广泛使用的避孕方法。观察性研究表明其使用可能与女性抑郁症状风险增加相关，但由于潜在的混杂因素，两者间的因果关系尚不明确。本研究通过系统评价与Meta分析，综合定量评估多种临床试验中口服避孕药使用与抑郁症状发生风险之间的关联。方法本研究系统检索了PubMed、Web of Science和Embase数据库（检索时间从建库到2025年10月18日），对多种临床试验进行了系统回顾和Meta分析，将随机接受任何形式口服避孕药的女性与随机接受任何其他形式避孕药或安慰剂的女性进行了比较。采用随机效应Meta分析合并风险比，同时对研究来源及抑郁症状评价进行亚组分析，探讨异质性来源。结果本研究共筛查1661项记录，最终纳入14项临床试验。采用随机效应模型进行Meta分析，结果显示：与对照组相比，口服避孕药的使用并未显著增加抑郁症状风险（RR=1.09，95% CI：0.83-1.42，P=0.54）。然而，不同研究之间呈现出显著的异质性特征，基于亚组的进一步分析结果表明，不同国家、研究方法、抑郁评估工具的研究中，口服避孕药对抑郁风险的影响可能存在差异。结论现有临床试验证据未表明口服避孕药会显著导致或增加成年女性的抑郁症状。但这并不表明口服避孕药对抑郁症状没有影响，异质性分析显示其影响在不同国家、使用不同的研究方法和抑郁评估工具中可能存在差异。未来的研究可以考虑从首次使用者、药物类型等角度出发进一步研究。

  关键词： 口服避孕药，抑郁症，Meta分析，女性抑郁症

   

  Abstract: Objective Oral contraceptives (OCs) are a widely used method of contraception globally. Observational studies suggest their use may be associated with an increased risk of depressive symptoms in women, but the causal relationship remains unclear due to potential confounding factors. This study aims to quantitatively evaluate the association between oral contraceptive use and the risk of depressive symptoms across multiple clinical trials through a systematic review and meta-analysis.Methods This study systematically searched the PubMed, Web of Science, and Embase databases (from inception to October 18, 2025). A systematic review and meta-analysis of clinical trials were conducted, comparing women randomly assigned to receive any form of oral contraceptives with those randomly assigned to receive any other form of contraception or placebo. A random-effects meta-analysis was used to pool risk ratios. Subgroup analyses based on study origin and the method of depressive symptom assessment were performed to explore sources of heterogeneity.Results A total of 1,661 records were screened, and 14 clinical trials were ultimately included. The random-effects meta-analysis showed that, compared to the control group, oral contraceptive use did not significantly increase the risk of depressive symptoms (RR = 1.09, 95% CI: 0.83–1.42, P = 0.54). However, significant heterogeneity was observed among the studies. Further subgroup analyses indicated that the impact of oral contraceptives on depression risk might vary across different countries, study methodologies, and depression assessment tools.Conclusion Current evidence from clinical trials does not indicate that oral contraceptives significantly cause or increase depressive symptoms in adult women. However, this does not imply that oral contraceptives have no effect on depressive symptoms. Heterogeneity analyses suggest that their effects may vary across different countries, study methodologies, and depression assessment tools. Future research could further investigate this association by considering factors such as first-time users and specific types of contraceptive formulations.

  Key words: Oral Contraceptives，Depression，A Meta-Analysis，Women’s Depression

  提交时间：2026-01-20

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• 序号	提交日期	编号	操作
  1	2026-01-07	10.12201/bmr.202601.00058V1	下载

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