Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Ctra de l'Institut Pere Mata, s/n., 43206, Reus, Tarragona, Spain.
Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS) Servizo Galego de Saúde (SERGAS), Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain.
Arch Womens Ment Health. 2020 Jun;23(3):413-420. doi: 10.1007/s00737-019-00989-x. Epub 2019 Aug 6.
Postpartum depression (PPD) is a common mood disorder that occurs after delivery with a prevalence of approximately 10%. Recent reports have related placental corticotropin-releasing hormone (pCRH) to postpartum depressive symptoms. The aim of this study was to determine whether pCRH, ACTH, and cortisol (measured 48 h after delivery) and glucocorticoid and mineralocorticoid receptor genotypes (NR3C1 and NR3C2) and their interaction are associated with PPD. A longitudinal 32-week prospective study of five hundred twenty-five Caucasian depression-free women that were recruited from obstetric units at two Spanish general hospitals immediately after delivery. Of the women included in the sample, forty-two (8%) developed PPD. A strong association between PPD and the interaction between the pCRH and NR3C2 rs2070951 genotype was observed. The mean level of pCRH in rs2070951GG carriers with PPD was 56% higher than the mean in the CG and CC genotype groups (P < 0.00005). Carriers of the rs2070951GG genotype with high levels of pCRH had a higher risk of developing PPD (OR = 1.020, 95% CI 1.007-1.034, P = 0.002). This association remained even after controlling for variables such as neuroticism, obstetric complications and the number of stressful life events during pregnancy. There is an important interaction between pCRH 48 h postpartum and the NR3C2 rs2070951GG genotype. This interaction moderately associates with the presence of PPD. These results may open a new line of research and, if confirmed in other settings, will help to identify better risk predictors and the treatment for PPD.
产后抑郁症（PPD）是一种常见的产后情绪障碍，其患病率约为 10%。最近的报告将胎盘促肾上腺皮质激素释放激素（pCRH）与产后抑郁症状联系起来。本研究旨在确定 pCRH、ACTH 和皮质醇（产后 48 小时测量）以及糖皮质激素和盐皮质激素受体基因型（NR3C1 和 NR3C2）及其相互作用是否与 PPD 相关。这是一项针对 525 名无抑郁的高加索女性的纵向 32 周前瞻性研究，这些女性是在分娩后立即从西班牙两家综合医院的产科病房招募的。在纳入的样本中，有 42 名（8%）女性出现 PPD。研究发现 PPD 与 pCRH 和 NR3C2 rs2070951 基因型的相互作用之间存在很强的关联。在 pCRH 中 rs2070951 GG 携带者中，与 CG 和 CC 基因型组相比，PPD 患者的 pCRH 平均水平高 56%（P<0.00005）。pCRH 水平高且携带 rs2070951 GG 基因型的携带者发生 PPD 的风险更高（OR=1.020，95%CI 1.007-1.034，P=0.002）。即使在控制了神经质、产科并发症和怀孕期间应激性生活事件数量等变量后，这种关联仍然存在。产后 48 小时 pCRH 与 NR3C2 rs2070951 GG 基因型之间存在重要的相互作用。这种相互作用与 PPD 的存在中度相关。这些结果可能开辟新的研究方向，如果在其他环境中得到证实，将有助于确定更好的风险预测因子和 PPD 的治疗方法。
