Boufidou Fotini, Lambrinoudaki Irini, Argeitis John, Zervas Ioannis M, Pliatsika Paraskevi, Leonardou Aggeliki A, Petropoulos Georgios, Hasiakos Dimitrios, Papadias Konstantinos, Nikolaou Chryssoula
Laboratory of Biopathology and Immunology, University of Athens, Eginition Hospital, Greece.
J Affect Disord. 2009 May;115(1-2):287-92. doi: 10.1016/j.jad.2008.07.008. Epub 2008 Aug 15.
Immune activation has been shown to be involved in the pathophysiology of anxiety states and major depression and pregnancy is associated with a characteristic immune activation to sustain the fetus. Despite the possibility of a relation between immune parameters and postpartum mood disturbance, few studies have explored this association. Further, no study to-date has examined CSF.
Fifty-six Greek parturients were recruited and a detailed medical and obstetric history was recorded. All of them completed the Postpartum Blues Questionnaire (on admission and on days 1-4 postpartum) and the Edinburgh Postnatal Depression Scale (at first and sixth week postpartum). At delivery, a blood sample and a CSF sample while puncturing for epidural analgesia were taken from 33 participants; blood samples only were obtained from the rest of the 23 parturients. TNF-a and IL-6 were quantified with an ELISA assay.
A multiple regression analysis of psychometric scores depending on cytokine levels revealed that cytokine levels were positively associated with depressive mood during the first four days postpartum (p=0.035 for CSF IL-6, p=0.025 for CSF TnF-a, p=0.023 for serum TnF-a) and also at sixth week postpartum (p=0.012 for CSF IL-6, p=0.072 for CSF TnF-a). Pregnancy duration had an adverse association to psychometric scores.
It is suggested that immune mechanisms may play a role in the etiopathology of postpartum depressive mood shifts. The role of a "rebound" reaction of the maternal immune system postnatal should be further investigated.
免疫激活已被证明参与焦虑状态和重度抑郁症的病理生理学过程，而妊娠与维持胎儿所特有的免疫激活相关。尽管免疫参数与产后情绪障碍之间可能存在关联，但很少有研究探讨这种关联。此外，迄今为止尚无研究检测脑脊液。
招募了56名希腊产妇，记录详细的医学和产科病史。她们所有人都完成了产后情绪低落问卷（入院时和产后第1 - 4天）以及爱丁堡产后抑郁量表（产后第一周和第六周）。分娩时，从33名参与者身上采集了血液样本和在进行硬膜外镇痛穿刺时采集了脑脊液样本；其余23名产妇仅采集了血液样本。采用酶联免疫吸附测定法对肿瘤坏死因子 - a（TNF - a）和白细胞介素 - 6（IL - 6）进行定量分析。
根据细胞因子水平对心理测量评分进行的多元回归分析显示，细胞因子水平与产后前四天（脑脊液IL - 6的p = 0.035，脑脊液TNF - a的p = 0.025，血清TNF - a的p = 0.023）以及产后第六周（脑脊液IL - 6的p = 0.012，脑脊液TNF - a的p = 0.072）的抑郁情绪呈正相关。妊娠持续时间与心理测量评分呈负相关。
提示免疫机制可能在产后抑郁情绪变化的病因学中起作用。产后母体免疫系统“反弹”反应的作用应进一步研究。
