The aim of this research was to study the long-term risk of de novo mental health conditions in women who underwent hysterectomy
with bilateral ovarian conservation compared with age-matched referent women.
Using the Rochester Epidemiology
Project records-linkage system, we identified a historical cohort of 2,094 women who underwent hysterectomy
with ovarian conservation for benign indications at age ≥18 years and with an index date between 1980 and 2002 in Olmsted County, Minnesota. Each woman was age-matched (±1 y) to a referent woman residing in the same county who had not undergone hysterectomy
or any oophorectomy before the index date. These two cohorts were followed historically to identify de novo mental health conditions. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) using Cox proportional hazards models adjusted for 20 preexisting chronic conditions and other potential confounders. We also calculated absolute risk increases (ARIs) and reductions (ARRs) at 30 years of follow-up.
Over a median follow-up of 21.9 years, women who underwent hysterectomy
at any age experienced increased risks of de novo depression
(adjusted HR 1.26; 95% CI, 1.12-1.41; ARI 6.6%) and anxiety
(adjusted HR 1.22; 95% CI, 1.08-1.38; ARI 4.7%). The association for depression
increased significantly with younger age at hysterectomy
, but did not vary significantly by indication. Interactions were not significant for anxiety
, even with ovarian conservation, is associated with an increased long-term risk of de novo depression
, especially when performed in women who are younger.