Qiong Sha1, Eric Achtyes2, Madhavi Nagalla2, Sarah Keaton3, LeAnn Smart4, Richard Leach5, Lena Brundin6. 1. Center of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA. Electronic address: jade.sha@vai.org. 2. Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA. 3. Center of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA. 4. Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA. 5. Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, MI, USA. 6. Center of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
Abstract
BACKGROUND: Depression during and after pregnancy is common, affecting at least 15% of women. Features of depression in pregnancy range from mild symptoms of disrupted mood and interest to severe depression and suicidal behavior. Previous studies suggest hormone- and immune dysregulations might contribute to post-partum depression, but consistent evidence is lacking. METHODS: A total of 163 women were included in the study in the post-partum. Peri-partum depression (PPD) was diagnosed using SCID interviews and depressive symptoms were quantified using the Edinburgh Perinatal Depression Rating Scale (EPDS), retrospectively long-term, as well as acutely. Plasma estrogen, progesterone, pro- and anti-inflammatory cytokines and kynurenine metabolites were measured in the post-partum. RESULTS: Higher estrogen and progesterone in the post-partum were linked to more severe depressive symptoms over pregnancy. In the post-partum, estrogen was positively correlated with the pro-inflammatory cytokine IL-6 and negatively correlated with kynurenine and picolinic acid. Conversely, progesterone was negatively correlated with IL-1β and several metabolites in the kynurenine pathway, including quinolinic acid. LIMITATIONS: Associative study design, did not attempt to assess causality. Did not adjust hormone levels for medication effects. CONCLUSIONS: Our study suggests that higher sex hormones in the post-partum are linked to depression severity over pregnancy. Estrogen was coupled with a pro-inflammatory profile and neurotoxic kynurenine metabolites, whereas progesterone was linked to an anti-inflammatory profile in the post-partum.
BACKGROUND: Depression during and after pregnancy is common, affecting at least 15% of women. Features of depression in pregnancy range from mild symptoms of disrupted mood and interest to severe depression and suicidal behavior. Previous studies suggest hormone- and immune dysregulations might contribute to post-partum depression, but consistent evidence is lacking. METHODS: A total of 163 women were included in the study in the post-partum. Peri-partum depression (PPD) was diagnosed using SCID interviews and depressive symptoms were quantified using the Edinburgh Perinatal Depression Rating Scale (EPDS), retrospectively long-term, as well as acutely. Plasma estrogen, progesterone, pro- and anti-inflammatory cytokines and kynurenine metabolites were measured in the post-partum. RESULTS: Higher estrogen and progesterone in the post-partum were linked to more severe depressive symptoms over pregnancy. In the post-partum, estrogen was positively correlated with the pro-inflammatory cytokine IL-6 and negatively correlated with kynurenine and picolinic acid. Conversely, progesterone was negatively correlated with IL-1β and several metabolites in the kynurenine pathway, including quinolinic acid. LIMITATIONS: Associative study design, did not attempt to assess causality. Did not adjust hormone levels for medication effects. CONCLUSIONS: Our study suggests that higher sex hormones in the post-partum are linked to depression severity over pregnancy. Estrogen was coupled with a pro-inflammatory profile and neurotoxic kynurenine metabolites, whereas progesterone was linked to an anti-inflammatory profile in the post-partum.
Authors: Samantha Meltzer-Brody; Helen Colquhoun; Robert Riesenberg; C Neill Epperson; Kristina M Deligiannidis; David R Rubinow; Haihong Li; Abdul J Sankoh; Christine Clemson; Amy Schacterle; Jeffrey Jonas; Stephen Kanes Journal: Lancet Date: 2018-08-31 Impact factor: 79.321
Authors: Yekta Dowlati; Nathan Herrmann; Walter Swardfager; Helena Liu; Lauren Sham; Elyse K Reim; Krista L Lanctôt Journal: Biol Psychiatry Date: 2009-12-16 Impact factor: 13.382