围产期抑郁症状女性的炎症标志物表达。
Expression of inflammatory markers in women with perinatal depressive symptoms.
机构信息
Department of Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, 119 Belmont Street, Worcester, MA, 01605, USA.
Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
出版信息
Arch Womens Ment Health. 2018 Dec;21(6):671-679. doi: 10.1007/s00737-018-0834-1. Epub 2018 Mar 30.
Perinatal depression affects 10-20% of women and is associated with poor outcomes for mother and child. Inflammation is associated with depression in non-pregnant adults. Perinatal depression and inflammation in pregnancy are independently associated with morbidities including obesity, gestational diabetes, preeclampsia, and preterm birth. The role of inflammation in perinatal depression has received little attention. We hypothesized an association between self-reported perinatal depressive symptoms and serum inflammatory biomarkers TNF-α, IL-6, IL-1β, and CRP. 110 healthy gravidas were recruited in third trimester from an academic medical center, with a baseline study visit at a mean of 32.5 (SD ± 1.8) weeks gestational age. Sixty-three participants completed the Edinburgh Postnatal Depression Scale (EPDS) and provided demographic information and serum samples upon enrollment and at 3 and 6 months postpartum. Serum inflammatory markers were quantified by multiplex array. Multiple linear mixed effects models were used to evaluate trends of biomarkers with the EPDS score in the third trimester of pregnancy and the postpartum period. Elevated serum TNF-α was associated with lower EPDS total score (β = - 0.90, p = 0.046) after adjusting for demographics and medication use. In contrast, IL-6, CRP, and IL-1β did not demonstrate statistically significant associations with depressive symptoms by the EPDS in either crude or adjusted models. Study findings showed no association or an inverse (TNF-α) association between inflammatory markers and perinatal depressive symptoms. Relevant literature evaluating a role for inflammation in depression in the unique context of pregnancy is both limited and inconsistent, and further exploration is merited.
围产期抑郁影响 10-20%的女性,并与母婴不良结局相关。在非孕妇人群中,炎症与抑郁相关。围产期抑郁和妊娠期间的炎症与多种疾病独立相关,包括肥胖、妊娠期糖尿病、子痫前期和早产。炎症在围产期抑郁中的作用尚未得到充分关注。我们假设围产期抑郁症状自评与血清炎症生物标志物 TNF-α、IL-6、IL-1β 和 CRP 之间存在关联。我们从学术医疗中心招募了 110 名健康孕妇,在妊娠 32.5 周(标准差 ± 1.8)时进行基线研究。63 名参与者完成了爱丁堡产后抑郁量表(EPDS),并在入组时以及产后 3 个月和 6 个月时提供了人口统计学信息和血清样本。通过多重微阵列分析来量化血清炎症标志物。采用多元线性混合效应模型评估妊娠晚期和产后 EPDS 评分与生物标志物的趋势。调整人口统计学和药物使用后,血清 TNF-α 水平升高与 EPDS 总分降低相关(β=-0.90,p=0.046)。相比之下,IL-6、CRP 和 IL-1β 在未调整和调整模型中均未显示与 EPDS 抑郁症状有统计学显著关联。研究结果表明,炎症标志物与围产期抑郁症状之间无关联或呈负相关(TNF-α)。评估炎症在妊娠这一独特背景下对抑郁作用的相关文献有限且不一致,值得进一步探索。