Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China.
Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, 100 Xianggang Rd, Jiangan District, Wuhan, Hubei, China.
J Psychosom Res. 2023 Mar;166:111101. doi: 10.1016/j.jpsychores.2022.111101. Epub 2022 Nov 22.
The prevalence of depression has increased dramatically in the past few decades, and pregnant women are at high risk for depression. It is widely thought that inflammation plays a critical role in the pathogenesis of depression. Therefore, we aimed to evaluate the association between the neutrophil-lymphocyte ratio (NLR), a marker of chronic immune inflammation, and perinatal depressive symptoms.
A cohort study involving 535 pregnant women was conducted based on a prospective birth cohort in Wuhan, China. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antepartum depression (APD) and postpartum depression (PPD) during the second trimester of pregnancy and one month after delivery. The NLR during the second trimester was determined based on a routine blood test. The association between NLR and depressive symptoms was evaluated using logistic regression analysis and restricted cubic spline (RCS) regression.
We found that the prevalence of APD and PPD was 8.4% and 15.1%, respectively. NLR levels were positively associated with APD (OR = 1.52, 95% CI: 1.20--1.91). After adjusting for potential confounders, the OR (95% CI) of APD for the highest NLR quartile was 4.56 (1.58, 13.13) compared with the lowest quartile. No significant association was found between NLR and PPD. RCS regression model analysis indicated a linear correlation between NLR and APD (P for non-linearity = 0.58).
Overall, elevated mid-trimester NLR is independently associated with APD but not PPD.
在过去几十年中，抑郁症的患病率急剧上升，孕妇患抑郁症的风险很高。人们普遍认为，炎症在抑郁症的发病机制中起着关键作用。因此，我们旨在评估中性粒细胞与淋巴细胞比值（NLR），一种慢性免疫炎症标志物，与围产期抑郁症状之间的关系。
基于中国武汉的一项前瞻性出生队列，进行了一项涉及 535 名孕妇的队列研究。使用爱丁堡产后抑郁量表（EPDS）评估妊娠中期和分娩后一个月的产前抑郁（APD）和产后抑郁（PPD）。根据常规血液检查确定妊娠中期的 NLR。使用逻辑回归分析和限制性立方样条（RCS）回归评估 NLR 与抑郁症状之间的关系。
我们发现 APD 和 PPD 的患病率分别为 8.4%和 15.1%。NLR 水平与 APD 呈正相关（OR=1.52，95%CI：1.20-1.91）。在校正潜在混杂因素后，最高 NLR 四分位组与最低四分位组相比，APD 的 OR（95%CI）为 4.56（1.58，13.13）。NLR 与 PPD 之间无显著相关性。RCS 回归模型分析表明 NLR 与 APD 之间存在线性相关（非线性 P 值=0.58）。
总体而言，妊娠中期 NLR 升高与 APD 独立相关，但与 PPD 无关。
