Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
NCRR - National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.
Transl Psychiatry. 2019 Nov 11;9(1):288. doi: 10.1038/s41398-019-0629-9.
Postpartum psychiatric disorders are heritable, but how genetic liability varies by other significant risk factors is unknown. We aimed to (1) estimate associations of genetic risk scores (GRS) for major depression (MD), bipolar disorder (BD), and schizophrenia (SCZ) with postpartum psychiatric disorders, (2) examine differences by prior psychiatric history, and (3) compare genetic and familial risk of postpartum psychiatric disorders. We conducted a nested case-control study based on Danish population-based registers of all women in the iPSYCH2012 cohort who had given birth before December 31, 2015 (n = 8850). Cases were women with a diagnosed psychiatric disorder or a filled psychotropic prescription within one year after delivery (n = 5829 cases, 3021 controls). Association analyses were conducted between GRS calculated from Psychiatric Genomics Consortium discovery meta-analyses for MD, BD, and SCZ and case-control status of a postpartum psychiatric disorder. Parental psychiatric history was associated with postpartum psychiatric disorders among women with previous psychiatric history (OR, 1.14; 95% CI 1.02-1.28) but not without psychiatric history (OR, 1.08; 95% CI: 0.81-1.43). GRS for MD was associated with an increased risk of postpartum psychiatric disorders in both women with (OR, 1.44; 95% CI: 1.19-1.74) and without (OR, 1.88; 95% CI: 1.26-2.81) personal psychiatric history. SCZ GRS was only minimally associated with postpartum disorders and BD GRS was not. Results suggest GRS of lifetime psychiatric illness can be applied to the postpartum period, which may provide clues about distinct environmental or genetic elements of postpartum psychiatric disorders and ultimately help identify vulnerable groups.
产后精神障碍是可遗传的,但遗传易感性如何因其他重大风险因素而异尚不清楚。我们旨在:(1) 估计重度抑郁症 (MD)、双相情感障碍 (BD) 和精神分裂症 (SCZ) 的遗传风险评分 (GRS) 与产后精神障碍的关联;(2) 检查既往精神病史的差异;(3) 比较产后精神障碍的遗传和家族风险。我们基于 iPSYCH2012 队列中的所有丹麦人群进行了一项嵌套病例对照研究,这些妇女在 2015 年 12 月 31 日前分娩过(n=8850)。病例为产后一年内诊断为精神障碍或服用精神药物的妇女(n=5829 例,3021 例对照)。在产后精神病病例与对照状态之间,进行了从 MD、BD 和 SCZ 的精神病基因组学联合会发现荟萃分析计算的 GRS 之间的关联分析。既往有精神病史的妇女产后精神病与父母的精神病史相关(OR, 1.14;95% CI 1.02-1.28),而无精神病史的妇女则无相关(OR, 1.08;95% CI: 0.81-1.43)。MD 的 GRS 与有(OR, 1.44;95% CI: 1.19-1.74)和无(OR, 1.88;95% CI: 1.26-2.81)个人精神病史的妇女产后精神障碍的风险增加相关。SCZ GRS 仅与产后障碍有轻微关联,BD GRS 则无。结果表明,终生精神疾病的 GRS 可应用于产后时期,这可能为产后精神障碍的独特环境或遗传因素提供线索,并最终有助于识别脆弱群体。