Christian Lisa M, Mitchell Amanda M, Gillespie Shannon L, Palettas Marilly
Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Psychoneuroendocrinology. 2016 Dec;74:69-76. doi: 10.1016/j.psyneuen.2016.08.025. Epub 2016 Aug 27.
Brain-derived neurotrophic factor (BDNF) is implicated as a causal factor in major depression and is critical to placental development during pregnancy. Longitudinal data on BDNF across the perinatal period are lacking. These data are of interest given the potential implications for maternal mood and fetal growth, particularly among Black women who show ∼2-fold greater risk for delivering low birth weight infants.
Serum BDNF, serum cortisol, and depressive symptoms (per CES-D) were assessed during each trimester and 4-11 weeks postpartum among 139 women (77 Black, 62 White). Low birth weight (<2500g) was determined via medical record.
Serum BDNF declined considerably from 1st through 3rd trimesters (ps≤0.008) and subsequently increased at postpartum (p<0.001). Black women exhibited significantly higher serum BDNF during the 1st trimester, 2nd trimester, and postpartum (ps≤0.032) as well as lower serum cortisol during the 2nd and 3rd trimester (ps≤0.01). Higher serum cortisol was concurrently associated with lower serum BDNF in the 2nd trimester only (p<0.05). Controlling for race, serum BDNF at both the 2nd and 3rd trimester was negatively associated with 3rd trimester depressive symptoms (ps≤0.02). In addition, women delivering low versus healthy weight infants showed significantly lower serum BDNF in the 3rd trimester (p=0.004). Women delivering low versus healthy weight infants did not differ in depressive symptoms at any time point during pregnancy (ps≥0.34).
Serum BDNF declines considerably across pregnancy in Black and White women, with overall higher levels in Blacks. Lower serum BDNF in late pregnancy corresponds with higher depressive symptoms and risk for low birth weight in Black and White women. However, the predictive value of serum BDNF in pregnancy is specific to within-race comparisons. Potential links between racial differences in serum BDNF and differential pregnancy-related cortisol adaptation require further investigation.
脑源性神经营养因子（BDNF）被认为是重度抑郁症的一个致病因素，并且在孕期胎盘发育过程中至关重要。目前缺乏围产期BDNF的纵向数据。鉴于其对母亲情绪和胎儿生长的潜在影响，这些数据具有重要意义，尤其是在分娩低体重婴儿风险约高2倍的黑人女性中。
对139名女性（77名黑人、62名白人）在孕期各阶段及产后4至11周评估血清BDNF、血清皮质醇和抑郁症状（采用CES - D量表）。通过病历确定低体重儿（<2500g）。
血清BDNF从孕早期到孕晚期显著下降（p值≤0.008），随后在产后升高（p<0.001）。黑人女性在孕早期、孕中期和产后血清BDNF显著更高（p值≤0.032），并且在孕中期和孕晚期血清皮质醇更低（p值≤0.01）。仅在孕中期，较高的血清皮质醇与较低的血清BDNF同时相关（p<0.05）。在控制种族因素后，孕中期和孕晚期的血清BDNF与孕晚期抑郁症状呈负相关（p值≤0.02）。此外，分娩低体重儿与健康体重儿的女性在孕晚期血清BDNF显著更低（p = 0.004）。分娩低体重儿与健康体重儿的女性在孕期任何时间点的抑郁症状均无差异（p值≥0.34）。
黑人女性和白人女性孕期血清BDNF均显著下降，黑人总体水平更高。孕晚期血清BDNF较低与黑人和白人女性较高的抑郁症状及低体重儿风险相关。然而，血清BDNF在孕期的预测价值特定于种族内比较。血清BDNF种族差异与妊娠相关皮质醇适应性差异之间的潜在联系需要进一步研究。
