Hu Jiajia, Zhou Borong, Li Yingtao, Deng Yanhua, He Qing, Ye Junwei, Ning Yuping
The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Department of Psychiatry, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Psychiatr Genet. 2019 Aug;29(4):97-102. doi: 10.1097/YPG.0000000000000222.
Although estrogenic fluctuation is considered a major risk factor for postpartum depression (PPD), the effects of the interactions between the genetic background and estradiol (E2) change on PPD are not well understood. Here, a cohort study with 437 postpartum women was carried out to evaluate the role of a serotonin transporter gene polymorphism (5-HTTLPR) and E2 change on the risk of PPD symptoms. The participants were assessed using the Edinburgh Postnatal Depression Scale and the Self-Rating Depression Scale at 1 and 6 weeks after delivery. The PCR-based restriction fragment length polymorphism method was utilized to examine the genotype distribution of the 5-HTTLPR polymorphism, and the serum levels of E2 were determined in individuals in the third trimester of pregnancy and at 1 week postpartum. A significant association was observed between E2 change and PPD susceptibility in the late postpartum period (6 weeks) [P = 0.002, odds ratio (OR) = 2.341, 95% confidence interval (CI) = 1.361-4.027], but it was not observed in the early postpartum period (1 week). There was no significant association between the 5-HTTLPR genotype and PPD risk at both the early and late postpartum periods (P > 0.05). However, the interaction between E2 change and the 5-HTTLPR polymorphism could reasonably influence PPD risk. The women who carried the SS genotype with large decreases in E2 showed a significantly higher risk for PPD at both the early (P = 0.002, OR = 2.525, 95% CI = 1.384-4.059) and late postpartum periods (P < 0.001, OR = 3.108, 95% CI = 1.562-4.436) compared with those who carried the SL/LL genotype. This study suggests that there is an association between E2 change in the perinatal period with the 5-HTTLPR genotype and the occurrence of PPD.
尽管雌激素波动被认为是产后抑郁症（PPD）的主要风险因素，但遗传背景与雌二醇（E2）变化之间的相互作用对PPD的影响尚未得到充分了解。在此，对437名产后女性进行了一项队列研究，以评估血清素转运体基因多态性（5-HTTLPR）和E2变化对PPD症状风险的作用。在分娩后1周和6周，使用爱丁堡产后抑郁量表和自评抑郁量表对参与者进行评估。采用基于聚合酶链反应的限制性片段长度多态性方法检测5-HTTLPR多态性的基因型分布，并测定妊娠晚期和产后1周个体的血清E2水平。在产后晚期（6周）观察到E2变化与PPD易感性之间存在显著关联[P = 0.002，优势比（OR）= 2.341，95%置信区间（CI）= 1.361 - 4.027]，但在产后早期（1周）未观察到。在产后早期和晚期，5-HTTLPR基因型与PPD风险之间均无显著关联（P > 0.05）。然而，E2变化与5-HTTLPR多态性之间的相互作用可能合理地影响PPD风险。与携带SL/LL基因型的女性相比，携带SS基因型且E2大幅下降的女性在产后早期（P = 0.002，OR = 2.525，95% CI = 1.384 - 4.059）和晚期（P < 0.001，OR = 3.108，95% CI = 1.562 - 4.436）患PPD的风险显著更高。这项研究表明围产期E2变化与5-HTTLPR基因型和PPD的发生之间存在关联。
