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孕早期血清脑源性神经营养因子(BDNF)浓度降低与产前抑郁的关联。

Association of decreased serum brain-derived neurotrophic factor (BDNF) concentrations in early pregnancy with antepartum depression.

作者信息

Fung Jenny, Gelaye Bizu, Zhong Qiu-Yue, Rondon Marta B, Sanchez Sixto E, Barrios Yasmin V, Hevner Karin, Qiu Chunfang, Williams Michelle A

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru.

出版信息

BMC Psychiatry. 2015 Mar 10;15:43. doi: 10.1186/s12888-015-0428-7.

Abstract

BACKGROUND

Antepartum depression is one of the leading causes of maternal morbidity and mortality in the prenatal period. There is accumulating evidence for the role of brain-derived neurotrophic factor (BDNF) in the pathophysiology of depression. The present study examines the extent to which maternal early pregnancy serum BDNF levels are associated with antepartum depression.

METHOD

A total of 968 women were recruited and interviewed in early pregnancy. Antepartum depression prevalence and symptom severity were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. Maternal serum BDNF levels were measured using a competitive enzyme-linked immunosorbent assay (ELISA). Logistic regression procedures were performed to estimate odds ratios (OR) and 95% confidence intervals (95% CI) adjusted for confounders.

RESULTS

Maternal early pregnancy serum BDNF levels were significantly lower in women with antepartum depression compared to women without depression (mean ± standard deviation [SD]: 20.78 ± 5.97 vs. 21.85 ± 6.42 ng/ml, p = 0.024). Lower BDNF levels were associated with increased odds of maternal antepartum depression. After adjusting for confounding, women whose serum BDNF levels were in the lowest three quartiles (<17.32 ng/ml) had 1.61-fold increased odds (OR = 1.61, 95% CI: 1.13, 2.30) of antepartum depression as compared with women whose BDNF levels were in the highest quartile (>25.31 ng/ml). There was no evidence of an association of BDNF levels with depression symptom severity.

CONCLUSIONS

Lower maternal serum BDNF levels in early pregnancy are associated with antepartum depression. These findings may point toward new therapeutic opportunities and BDNF should be assessed as a potential biomarker for risk prediction and monitoring response to treatment for antepartum depression.

摘要

背景

产前抑郁是孕期孕产妇发病和死亡的主要原因之一。越来越多的证据表明脑源性神经营养因子(BDNF)在抑郁症的病理生理学中发挥作用。本研究旨在探讨孕早期母体血清BDNF水平与产前抑郁的关联程度。

方法

共招募968名妇女在孕早期进行访谈。使用患者健康问卷-9(PHQ-9)量表评估产前抑郁患病率和症状严重程度。采用竞争性酶联免疫吸附测定(ELISA)法检测母体血清BDNF水平。进行逻辑回归分析以估计调整混杂因素后的比值比(OR)和95%置信区间(95%CI)。

结果

与无抑郁的妇女相比,产前抑郁妇女的孕早期母体血清BDNF水平显著降低(均值±标准差[SD]:20.78±5.97 vs. 21.85±6.42 ng/ml,p = 0.024)。BDNF水平较低与母体产前抑郁几率增加相关。调整混杂因素后,血清BDNF水平处于最低三个四分位数(<17.32 ng/ml)的妇女产前抑郁几率比BDNF水平处于最高四分位数(>25.31 ng/ml)的妇女增加1.61倍(OR = 1.61,95%CI:1.13,2.30)。没有证据表明BDNF水平与抑郁症状严重程度相关。

结论

孕早期母体血清BDNF水平较低与产前抑郁相关。这些发现可能指向新的治疗机会,BDNF应作为产前抑郁风险预测和治疗反应监测的潜在生物标志物进行评估。

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