Division of Women, Children, and Family Health, The College of Nursing, The University of Colorado-Denver, Aurora, CO 80045, USA.
Biol Res Nurs. 2010 Jul;12(1):73-83. doi: 10.1177/1099800410362112. Epub 2010 May 7.
Postpartum depression (PPD) is a serious mood disorder that may carry life-long consequences for a woman and her family. Multiple risk factors for PPD have been identified, including psychosocial, situational, and biological stimuli, several of which are experienced by most, if not all, postpartum women. Given the commonality of these risk factors, it is unclear why fewer than 20% of postpartum women actually develop PPD. In this review, we suggest that different susceptibility to PPD among postpartum women may be explained by the presence or absence of genetic variants that confer increased risk. We review three categories of genes known to code for proteins associated with depression in the general population or proteins known to be affected by childbirth for their possible association with PPD, including genes related to central nervous system monoamine availability, proinflammatory cytokines, and brain neuropeptides. Only two studies are available in the literature to date specifically looking at polymorphisms in postpartum women as related to PPD; both are concerned with monoamine availability. These are discussed in further depth. Conclusions regarding the contribution of genetic polymorphisms to the development of PPD are mixed. Ultimately, the complexity of the disorder and the interrelationships among different genes thought to contribute to depression suggest that much more research is required to understand the heritability of PPD. The complexity of the disorder also suggests that epigenetic influences must be considered as well when discussing susceptibility.
产后抑郁症(PPD)是一种严重的情绪障碍,可能会对女性及其家庭造成终身影响。已经确定了多种 PPD 的风险因素,包括心理社会、情境和生物刺激,其中有几个因素是大多数(如果不是全部)产后女性都会经历的。鉴于这些风险因素的普遍性,尚不清楚为什么只有不到 20%的产后女性实际上会患上 PPD。在这篇综述中,我们认为,产后女性对 PPD 的不同易感性可能可以用存在或不存在增加风险的遗传变异来解释。我们回顾了三类已知与一般人群中抑郁相关的蛋白质或已知受分娩影响的蛋白质相关的基因,以探讨它们与 PPD 的可能关联,这些基因包括与中枢神经系统单胺可用性、促炎细胞因子和脑神经肽相关的基因。迄今为止,文献中只有两项专门针对与 PPD 相关的产后妇女中多态性的研究;两者都与单胺可用性有关。这些将进一步深入讨论。关于遗传多态性对 PPD 发展的贡献的结论是混杂的。最终,该疾病的复杂性以及被认为有助于抑郁的不同基因之间的相互关系表明,需要进行更多的研究才能了解 PPD 的遗传性。该疾病的复杂性还表明,在讨论易感性时,还必须考虑表观遗传的影响。